Cases Of High Myopia Research Articles

A novel variant in the keratin 12 gene in a four-generation Chinese family with high myopia.

High myopia is a major cause of visual impairment, and genetic factors play crucial roles in the pathogenesis. We performed this study to identify candidate genes for the development of high myopia in a four-generation Chinese family with myopia. All family members with myopia and 100 healthy participants were included in this study. Data were obtained on demographics, disease history, and ocular examination results. We performed whole exome sequencing of the genomic DNA and Sanger sequencing to verify the variants. Functional analyses of the variant were performed using software programmes. Nine of thirteen family members were found to have high myopia, amongst which two members were also diagnosed keratoconus. A missense variant in the keratin 12 gene (KRT12, p.Val410Gly) was detected in all high myopia cases but not in other family members without high myopia or the controls. The variant was predicted to be benign by online software programmes. However, modelling of the three-dimensional structure of the protein clearly revealed conformational changes caused by the mutation. A missense mutation in the KRT12 gene was identified in this Chinese family, which may be associated with the pathogenesis of high myopia.

Choroidal thinning in myopia is associated with axial elongation and severity of myopic maculopathy

High myopia can lead to pathologic myopia and visual impairment, whereas its causes are unclear. We retrospectively researched high myopia cases from patient records to investigate the association between axial elongation and myopic maculopathy. Sixty-four eyes were examined in patients who visited the department between July 2017 and June 2018, had an axial length of 26 mm or more, underwent fundus photography, and had their axial length measured twice or more. The average axial length was 28.29 ± 1.69 mm (mean ± standard deviation). The average age was 58.3 ± 14.4 years old. Myopic maculopathy was categorized as mild (grades 0 and 1) and severe (grades 2, 3, and 4). The severe group had longer axial lengths than the mild group (P < 0.05). Moreover, the severe group exhibited thinner choroidal thickness than the mild group (P < 0.05). When subjects were grouped by axial elongation over median value within a year, the elongation group showed thinner central choroidal thickness than the non-elongation group (142.1 ± 91.9 vs. 82.9 ± 69.8, P < 0.05). In conclusion, in patients with high myopia, the severity of maculopathy correlated with choroidal thickness and axial length. Thinner choroidal thickness was associated with axial elongation based on the baseline axial length.

Systematic evaluation of machine learning-enhanced trifocal IOL power selection for axial myopia cataract patients

PurposeThis study aimed to evaluate and optimize intraocular lens (IOL) power selection for cataract patients with high axial myopia receiving trifocal IOLs. DesignA multi-center, retrospective observational case series was conducted. Patients having an axial length ≥26 mm and undergoing cataract surgery with trifocal IOL implanted were studied. MethodsPreoperative biometric and postoperative outcome data from 139 eyes were collected to train and test various machine learning (ML) models (support vector machine, linear regression, and stacking regressor) using five-fold cross-validation. The models' performance was further validated externally using data from 48 eyes enrolled from other hospitals. Performance of seven IOL calculation formulas (BUII, Kane, EVO, K6, DGS, Holladay I, and SRK/T) were examined with and without ML models. ResultsThe results of cross-validation revealed improvements across all IOL calculation formulas, especially for K6 and Holladay I. The model increased the percentage of eyes with a prediction error (PE) within ±0.50 D from 71.94% to 79.14% for K6, and from 35.25% to 51.80% for Holladay I. In external validation involving 48 patients from other centers, six out of seven formulas demonstrated a reduction in the mean absolute error (MAE). K6's PE within ±0.50 D improved from 62.50% to 77.08%, and Holladay I from 16.67% to 58.33%. ConclusionsIn this study, we conducted a comprehensive evaluation of seven IOL power calculation formulas in high axial myopia cases and explored the effectiveness of the Stacking Regressor model in augmenting their accuracy. Of these formulas, K6 and Holladay I exhibited the most significant improvements, suggesting that integrating ML may have varying levels of effectiveness across different formulas but holds substantial promise in improving the predictability of IOL power calculations in patients with long eyes.

CCDC66 mutations are associated with high myopia through affected cell mitosis

BackgroundHigh myopia (HM) refers to an eye refractive error exceeding −5.00 D, significantly elevating blindness risk. The underlying mechanism of HM remains elusive. Given the extensive genetic heterogeneity and vast...

Exome sequencing reveals PPEF2 variant associated with high myopia

High myopia (HM) is a serious blinding eye disease, and genetic factors play an important role in the development of HM. In this study, whole exome sequencing (WES) was used to identify a novel variant c.A875G of the PPEF2 for a large Uyghur family with nonsyndromic HM. The variant was verified to cosegregate with HM in the family using Sanger sequencing. Another novel variant c.1959C > G in PPEF2 was identified in one of 100 sporadic cases of HM by multiplex PCR targeted amplicon sequencing (MTA-seq). The Ppef2 was verified that mainly expressed in the retinal pigment epithelium (RPE), choroid and retina tissues. Immunofluorescence (IF) and immunohistochemistry (IHC) assays showed that the PPEF2 was strongly expressed in the inner segment layer formed by photoreceptor protrusions, as well as in the outer nuclear layer. Compared with the wild-type, the c.A875G resulted in reduced protein levels but had no effect on protein subcellular localization in cells. In addition, the c.A875G variant resulted in a decreased migratory and proliferative capacity but promoted apoptosis in cells. In summary, PPEF2 was identified as a novel HM-causing gene, and this variant in PPEF2 might cause HM by regulating the migration, proliferation and apoptosis of myopia-related cells.

Yokoyama procedure for cyclic strabismus with axial high myopia:a case report

BackgroundIt is a very rare form of ocular motility characterized by alternating strabismus and orthotropia. We report a patient with a 48-h cycle of esohypotropia associated with axial high myopia that resolved by Yokoyama procedure.Case presentationA 43-year-old female patient who underwent left medial rectus muscle recession and lateral rectus muscle resection elsewhere due to highly myopic strabismus 2 years ago. The patient experienced a recurrence of left esohypotropia 12 months after undergoing surgery, exhibiting a 48-hour cycle. The cycle is one full day of esohypotropia and one day of orthotropia. The patient exhibited a case of high myopia in the left eye, characterized by a diopter measurement of -24.00DS and an eye axis measurement of 28.43 mm. Orbital CT showed supertemporal dislocation of the posterior portion of the elongated globe out from the muscle cone. Based on these observations, we performed Yokoyama procedure by uniting the muscle bellies of the superior rectus(SR) and lateral rectus (LR) muscles to restoring the dislocated globe back into the muscle cone.ConclusionsWhen cyclic strabismus is combined with axial high myopia, the Yokoyama procedure was effective and cycles are successfully terminated without overcorrection on no squint days. The purpose of this procedure is to put the dislocated globe back into its muscle cone by uniting the muscle bellies of the superior rectus and lateral rectus.

The SNTB1 and ZFHX1B gene have susceptibility in northern Han Chinese populations with high myopia

The aim of this study was to explore the association between SNTB1 and ZFHX1B polymorphisms and high myopia (HM) in a Northern Han Chinese population. This case-control study included 457 HM and 860 healthy subjects from the Northern Han Chinese population. Four single nucleotide polymorphisms (SNPs) (rs7839488, rs4395927, rs4455882, and rs6469937) in SNTB1 and one SNP in ZFHX1B (rs13382811)were selected based on two previous genome-wide association study (GWAS) studies. The allele and genotype distributions of SNPs in SNTB1 and ZFHX1B were compared between the two groups using the chi-square test. The allele results were adjusted for age and sex using Plink software (Plink 1.9). Pairwise linkage disequilibrium (LD) and haplotype analyses were performed using SHEsis software. For HM subjects, the mean age was 44.80 ± 17.11 years, and for the control subjects, it was 44.41 ± 14.26 years. For rs7839488 of the SNTB1 gene, the A allele is a risk allele and the G allele is a wild allele. The A allele had no statistical significance with the HM cases and controls (OR = 0.90, 95% CI = 0.74–1.09, aP = 0.273, Pc = NS). There was a LD in SNTB1 (rs7839488, rs4395927, rs4455882, and rs6469937). The G-C-A-G haplotype frequency was higher in HM subjects than that of the controls (OR = 1.31, 95% CI = 1.07–1.60, P = 0.008). Meanwhile, the A-T-G-A haplotype frequency was slightly lower in the HM group (OR = 0.81, 95% CI = 0.66–0.99, P = 0.048). In the ZFHX1B gene, the frequency of the minor T allele of rs13382811 was significant higher in the HM group than in the control group (OR = 1.34, 95% CI = 1.11–1.61, aP = 0.001, Pc = 0.009). Furthermore, compared to the CC genotype, there were significant differences in the CT genotype (OR = 1.57, 95% CI = 1.23–2.00, aP < 0.001, Pc = 0.002). In conclusion, G-C-A-G is a risk haplotype from the SNTB1 gene in high myopia patients. The minor T-allele of ZFHX1B rs13382811 is a risk factor for high myopia. SNTB1 and ZFHX1B are both risk genes associated with increased susceptibility to high myopia in the Northern Han Chinese population.

Association of mitochondrial DNA variation with high myopia in a Han Chinese population

High myopia (HM), which is characterized by oxidative stress, is one of the leading causes of visual impairment and blindness across the world. Family and population genetic studies have uncovered nuclear-genome variants in proteins functioned in the mitochondria. However, whether mitochondrial DNA mutations are involved in HM remains unexplored. Here, we performed the first large-scale whole-mitochondrial genome study in 9613 HM cases and 9606 control subjects of Han Chinese ancestry for identifying HM-associated mitochondrial variants. The single-variant association analysis identified nine novel genetic variants associated with HM reaching the entire mitochondrial wide significance level, including rs370378529 in ND2 with an odds ratio (OR) of 5.25. Interestingly, eight out of nine variants were predominantly located in related sub-haplogroups, i.e. m.5261G > A in B4b1c, m.12280A > G in G2a4, m.7912G > A in D4a3b, m.94G > A in D4e1, m.14857 T > C in D4e3, m.14280A > G in D5a2, m.16272A > G in G2a4, m.8718A > G in M71 and F1a3, indicating that the sub-haplogroup background can increase the susceptible risk for high myopia. The polygenic risk score analysis of the target and validation cohorts indicated a high accuracy for predicting HM with mtDNA variants (AUC = 0.641). Cumulatively, our findings highlight the critical roles of mitochondrial variants in untangling the genetic etiology of HM.

Sequencing of 19,219 exomes identifies a low-frequency variant in FKBP5 promoter predisposing to high myopia in a Han Chinese population

High myopia (HM) is one of the leading causes of visual impairment and blindness worldwide. Here, we report a whole-exome sequencing (WES) study in 9,613 HM cases and 9,606 controls of Han Chinese ancestry to pinpoint HM-associated risk variants. Single-variant association analysis identified three newly identified -genetic loci associated with HM, including an East Asian ancestry-specific low-frequency variant (rs533280354) in FKBP5. Multi-ancestry meta-analysis with WES data of 2,696 HM cases and 7,186 controls of European ancestry from the UK Biobank discerned a newly identified European ancestry-specific rare variant in FOLH1. Functional experiments revealed a mechanism whereby a single G-to-A transition at rs533280354 disrupted the binding of transcription activator KLF15 to the promoter of FKBP5, resulting in decreased transcription of FKBP5. Furthermore, burden tests showed a significant excess of rare protein-truncating variants among HM cases involved in retinal blood vessel morphogenesis and neurotransmitter transport.

Surgical management of exotropia‐hypotropia complex in high myopia

AbstractPurpose: We present an atypical clinical case of high myopia associated with divergent and vertical strabismus in the left eye (LE).Methods: A 50‐year‐old woman with a history of high myopia and deep amblyopia in the left eye (LE) referred to our center for surgical evaluation of LE exotropia. The clinical examination shows visual acuity (VA) of 10/10 in the right eye (RE) and light perception (LP) in LE. The Cover Test found an exotropia and hypotropia of the LE. In the funduscopic exam of the LE an advanced myopic choroiditis can be seen. Biometry shows an axial length (AL) of 25.10 mm in the RE and 32.25 mm in the LE. A magnetic resonance imaging (MRI) is performed where no pathological findings are evident. It was decided to intervene on the patient with divergent and vertical strabismus of the LE. Under general anaesthesia, a 7 mm shortening of the medial rectus muscle is performed with superior displacement of the insertion. In addition, a 9 mm retroinsertion of the lateral rectus muscle of the LE is performed with plication of the muscle to its anatomical position.Results: After surgery, the patient presented orthotropia without rectification.Conclusions: Exotropia‐hypotropia complex can be related with high myopia. The combination of resection and displacement of the insertion of the medial rectus together with recession and plication of the lateral rectus to its anatomical position was found to be effective in correcting the ocular deviation.

Discerning Between Macular Hemorrhages Due to Macular Neovascularization or Due to Spontaneous Bruch's Membrane Rupture in High Myopia: A Comparative Analysis Between OCTA and Fluorescein Angiography.

IntroductionTo evaluate the sensitivity and specificity of optical coherence tomography angiography (OCTA) in comparison to fluorescein angiography (FA) in discerning between macular hemorrhages due to myopic macular neovascularization (m-MNV) and idiopathic macular hemorrhage (IMH) in patients with high myopia (HM).MethodsIn this retrospective study, 14 eyes of 14 patients (mean age 60 ± 16 years) affected by macular hemorrhage due to HM were included. All patients underwent OCTA and FA at the time of macular hemorrhage (i.e., baseline) and were followed for a 3-month follow-up.ResultsBy means of FA, 8 out of 14 eyes with macular hemorrhage (57%) were diagnosed as type 2 m-MNV, whereas 6 eyes (43%) were diagnosed as IMH. Interestingly, OCTA displayed the presence of a neovascular network in all cases previously diagnosed as m-MNV using FA, and also excluded the presence of anomalous flow in all IMH eyes. This accounted for the high sensitivity and specificity of OCTA for m-MNV detection in HM cases with macular hemorrhage. After 3-month follow-up, BCVA improved from 0.39 ± 0.15 to 0.21 ± 0.14 logMAR (p = 0.006) in patients with m-MNV treated by a mean of 2.3 ± 0.9 intravitreal anti-VEGF injections. Conversely, BCVA improved without treatment (from 0.55 ± 0.48 to 0.17 ± 0.08 logMAR, p = 0.112) in patients with IMH.ConclusionsOCTA is able to differentiate with excellent reliability between the presence of m-MNV in patients with HM presenting with a new macular hemorrhage and an IMH. This could be of paramount relevance in the clinical setting for the diagnosis and treatment of patients with HM.

Effect of Phacoemulsification and Intraocular Lens Implantation on High Myopia with Cataract

Objective:To observe the clinical effect of phacoemulsification and intraocular lens implantation for high myopia with cataract. Results: To analyze 144 cases (152 eyes) of high myopia with cataract, male 78 cases (84 eyes), female 66 cases (68 eyes); age between 45~81 years old, average 65.26 years old; Axis oculi length 6.47~34.04mm, average 29.82mm. Nuclear lens opacities 86 eyes, Posterior subcapsular opacity 38 eyes, Cortical opacity 28 eyes; Nuclear hardness grading standards by Emery, 42 eyes nuclear grade Ⅱ, 72eyes nuclear grade Ⅲ, 34 eyes nuclear grade Ⅳ, 4 eyes nuclear grade V; Before the surgery, corrects defects of vision ≤0.1 in 120 eyes(79%), 0.1～0.2 in 32 eyes(21%), All patients under the topical anesthesia received the phacoemulsification and intraocular lens implantation. Results: After operation all the patients’ vision 0.5 in 78 eyes(51%), 0.2～0.4 in 56 eyes(37%), 0.1 in 18 eyes(12%), Compared with before operation, the enhancement of vision has a statistics significance(P0.01). Intraoperative, posterior capsule rupture is 2 cases(1.3%); No one has high intraocular pressure after operation, Cornea dropsy is 32 eyes(21%), after 3~7 d anti-SARS, just right for the illness treatments, cornea dropsy abates. After 3~6 months, no one has after-cataract in all patients. Conclusion: This is an effective treatment of phacoemulsification and intraocular lens implantation for high myopia with cataract and may improve the patients’ vision obviously and their quality of life.

Влияние жизнедеятельности в условиях цифровой среды на состояние органа зрения обучающихся

The growth of eye disease incidence in the juvenile population amidst increasing visual load, which, among other factors, results from the use of electronic devices (ED), outlines the search for effective preventive measures, geared towards preservation of health of young people. The study was aimed to assess the impact of life activity upon exposure to digital environment on the organ of sight in schoolchildren and college students. The study was carried out in 2017-2020 at Dolgoprudny gymnasium and Pirogov Russian National Research Medical University. A total of 805 schoolchildren and college students underwent ophthalmologic examination. Accommodative response was registered with Speedy-K Ver. MF-1 autorefractor keratometer (Japan). A standardized questionnaire, tailored by the authors to meet the requirements of the study, was used to assess the regime for the use of ED by students. Inclusion criteria: schoolchild, college student, ophthalmologic examination data and submitted informed consent available, correctly completed questionnaire. Statistical processing was performed using the Statistica 13.0 software. All students were the ED owners. Only 9.9% of primary school students, 2.7% of secondary school students, 1.9% of senior secondary school students, and 0.9% of college students did not use ED every day. Significant negative correlation was revealed between the students’ vision acuity and the daily total time of using the ED, as well as the duration of the ED continuous use (р≤0.05). Accommodation weakness was detected in 88.76% of students with early stage of myopia; accommodative response close to normal was less common (11.24%). The increase in daily total time of using the ED by 2 hours and more results in higher prevalence of functional vision problems (p≤0.05), and the trend of increasing the number of high myopia cases. The data obtained define the need of improving the students’ hygiene training starting from the preschool age.

Bilateral open-angle glaucoma in a young female with Desbuquois syndrome

Desbuquois dysplasia is characterized by the presence of short stature, short extremities, joint laxity with frequent dislocation, osteopenia, vertebral abnormalities, distinctive facial characteristics, and other abnormalities including myopia and glaucoma. A variant form of Desbuquois type skeletal dysplasia (DBQD), the Kim variant, has also been described and is characterized by short stature, joint, and minor facial anomalies. Here, we report a case of bilateral open-angle glaucoma and high myopia occurring in a young female who presented with Desbuquois syndrome, a rare type of osteochondrodysplasia. The patient presented to the ophthalmology clinic with persistent eye pain and unstable refractive error. Her preliminary examination revealed raised intraocular pressure, high myopia, and skeletal deformities. A complete systemic examination and genetic workup suggested DBQD, Kim variant. With no detailed ophthalmic reports of such patients existing in the literature, it is important that such patients undergo a complete ophthalmic survey to rule out glaucoma, high myopia, and strabismus.

Matched comparison of corneal higher order aberrations induced by SMILE to femtosecond assisted LASIK and to PRK in correcting moderate and high myopia: 3.00mm vs. 6.00mm

BackgroundThe refractive surgeries induce corneal higher order aberrations (C-HOAs). In this study, change of C-HOAs after small-incision lenticule extraction (SMILE) compared to femtosecond assisted laser in situ keratomileusis (femto-LASIK), and to photorefractive keratectomy with mitomycin-C (PRK) under photopic and mesopic conditions.MethodsIn this prospective study, age, gender, and apical corneal thickness (ACT) matched cases with moderate myopia [spherical equivalent (SE) 3.00 to 6.00D) to high myopia (SE > 6.00D)] were enrolled. In addition to visual acuity and refraction, total C-HOA, coma, spherical aberration (SA), and trefoil in the 3- and 6-mm zones were measured before and 3 and 6 months after surgery.ResultsOverall, 372 moderate myopia cases (124 eyes of 124 individuals in each surgical group) and 171 high myopia cases (57 eyes of 57 individuals in each surgical group) were enrolled. At baseline, the differences in age, gender, ACT, uncorrected and corrected visual acuity, and SE were not statistically significant between subgroups of surgical methods within each myopia group (all P > 0.05). At 12 months, in the moderate myopia group, there was less increase in 6-mm zone total C-HOA, coma, and SA with SMILE compared to the other groups (all P < 0.05). In the high myopia group, there was greater increase in photopic total C-HOA and trefoil and less increase in mesopic SA with SMILE (all P < 0.05).ConclusionsIn correction of moderate myopia, SMILE has better results in mesopic condition. In high myopia correction, femto-LASIK and PRK have better results in photopic and SMILE in mesopic condition.

The Impact of Eye Exercises on High Myopia and Visual Acuity in Patients Aged (15-30) Years

High myopia is a state in which the spherical equivalent objective refractive error is ≤ -5.00 Diopters (D) in either eye. Currently, there are several treatment options to correct high myopia including laser eye surgery, refractive lens exchange, pharmaceutical treatment, and others. This study focuses on physiotherapy treatment and aims to evaluate the potential advantage of applying new physical exercises for the eyes of patients aged between 15-30 years, was applied on 50 patients with a known case of high myopia who were recruited through criteria based purposive sampling, they visit the optical clinic routinely at the Medical Technical University. The optometrist assessed the refractive errors and visual acuity of subjects using a Snellen’s chart and an auto refractometer, then the eye exercises treatment was done by the specialist physician. The effect of physical exercises on the eyes was determined by comparing the visual acuity of patients before and after the treatment through the SPSS program, and the result was found to be significant with a P-value = 0.0281<0.05. Therefore, eye exercises provide an enhancement in visual acuity, ocular health, and correct the refractive error of high myopia resulting in better vision.

Genetic association study of SOX2 gene polymorphisms with high myopia in a Chinese population.

The aim of this study is to investigate whether SOX2 gene variants were associated with high myopia in a Chinese population. This study is conducted using case-control association analysis. This study recruited 83 healthy controls (with binocular spherical equivalent between -0.50 and +0.50 D) and 117 high myopia cases (spherical equivalent > -6.00 D in both eyes). Three single-nucleotide polymorphisms were selected from HapMap database for genotyping by direct sequencing. Statistical software (SPSS 22.0) was used for statistical analysis. The chi-square test was used to examine the difference in the frequency between cases and controls. Genotype distributions in the three single-nucleotide polymorphisms were all in accordance with the Hardy-Weinberg equilibrium. The differences of rs4575941 locus genotype frequency and allele frequency between the case group and the control group were statistically significant (p = .043 and p = .029, respectively). The rs4575941 allele G frequency in the high myopia group was significantly higher than that in the control group with an odds ratio value of 1.579. However, the value of a chi-square test for the trend was 0.029, and after Bonferroni test, the p value was .087. In Chinese population, rs4575941 in SOX2 gene was likely to play some roles in the genetic susceptibility to high myopia; the rs4575941 allele G might be a risk gene for high myopia.

Evaluation on the efficacy of posterior scleral reinforcement for the treatment of high myopia with post-scleral staphyloma

Objective To evaluate the efficacy of posterior scleral reinforcement in patients with high myopia with post-scleral staphyloma. Methods The data of 102 eyes of 62 cases of high myopia with post-scleral staphyloma in this hospital from Jun.2016 to Apr.2018 were collected. All cases received posterior scleral reinforcement.The followed-up time was 6-10 months. Results The differences of postoperative diopter, axial length and the best corrected visual acuity were statistically significant between before and after surgery (P 0.05). No serious complication such as ischemic optic neuropathy, retinal detachment or infection occurred. Conclusion Posterior scleral reinforcement in the treatment of high myopia with post-scleral staphyloma can effectively control the diopter and axial growth, as well as improve the visual acuity. Key words: Myopia, high; Staphyloma, posterior sclera; Reinforcement, posterior scleral; Parameters, hemodynamic

Application of femtosecond laser technology in the management of subluxated lens

To evaluate the application of femtosecond laser technology in the management of subluxated lens. We retrospectively analyzed the data of the patients with subluxated lens undergoing femtosecond laser- assisted surgery at the Cataract Center of Guangzhou Aier Eye Hospital between March, 2017 and May, 2019. The LenSx femtosecond laser-assisted cataract surgery system was used to perform capsulotomy and lens fragmentation. According to the patients' eye condition, anterior vitrectomy was performed and capsular retractors was used. After phacoemulsification, I/A and insertion of the tension rings, the intraocular lens (IOL) was implanted into the capsular bag. The perioperative data, complications, visual acuity and intraocular pressure after the operation were recorded, and the stability of the capsular bag and IOLs were assessed. We analyzed the data of 25 cases (29 eyes) of subluxated lens, including 16 (16 eyes; 55.17%) as the result of traumatic lens subluxation, 5 (9 eyes; 31.03%) of Mafan syndromes, 1 case (1 eye; 3.45%) of high myopia and 3 cases (3 eyes; 10.34%) of unknown causes. Thirteen 13 eyes (44.83%) showed mild subluxation, 7 (24.14%) had moderate subluxation, and 9 (31.03%) had severe subluxation. Femtosecond laser- assisted capsulorhexis, lens fragmentation and phacoemulsification were successfully completed for 29 eyes, of which 28 eyes (96.55%) retained the complete capsular bag and with successful implantation of the capsular tension devices and IOLs. Nine eyes (31.03%) were treated with anterior segment vitrectomy; iris hooks were used for 2 eyes (6.90%) and capsular bag hooks for 9 eyes (31.03%). The best corrected visual acuity was significantly improved in 29 eyes after operation (P &lt; 0.05). At 1 month after the surgery, 26 eyes (89.66%) showed stably centered IOLs, 2 eyes (6.90%) showed slight tilt of the IOLs, and 3 eyes (10.34%) had anterior capsular contraction. The intraoperative complications included subconjunctival hemorrhage (75.87%), incomplete capsulotomy (17.24%) and contracted pupils (13.79%). The application of femtosecond laser assisted technology enhances the surgical safety and effectiveness for subluxated lens, facilitates the choice of individualized surgical options, and promotes maximum recovery of the patients' visual function.

Serum metabolomics profiling and potential biomarkers of myopia using LC-QTOF/MS

Myopia is the most common form of refractive eye disease, and the prevalence is increasing rapidly worldwide. However, the key metabolic alterations in individuals with high myopia are not understood clearly, and serum biomarkers remain to be determined. The objectives of this study were to identify serum biomarkers and investigate the metabolic alterations of myopia. The serum metabolomics profiling was investigated on 30 high myopia cases and 30 controls (without myopia) using liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QTOF/MS), and an independent additional cohort including 20 cases and 19 controls were investigated to validate potential metabolite candidates for biomarkers. According to the metabolic differences, the myopia patients and controls could be divided into different clusters and nine metabolites were found to be closely correlated with myopia. In the cohort of validation, eight metabolites were confirmed. Metabolic pathway analyses of these metabolites of high myopia involved abnormal phospholipid, diacylglycerol, amino acid, and vitamin metabolism, which were closely correlated with oxidative stress and inflammation. Multiple logistic regression analyses showed that γ-glutamyltyrosine and 12-oxo-20-trihydroxy-leukotriene B4 were potential biomarkers of myopia with a combined high sensitivity (97%), specificity (90%), and area under the curve value (0.983). These findings may contribute to an understanding of the pathophysiological changes and pathogenesis of myopia, and provide novel insight into the early prevention and control of high myopia.