Major Eye Diseases Research Articles

Application of Artificial Intelligence in Ophthalmology: An Updated Comprehensive Review.

Artificial intelligence (AI) holds immense promise for transforming ophthalmic care through automated screening, precision diagnostics, and optimized treatment planning. This paper reviews recent advances and challenges in applying AI techniques such as machine learning and deep learning to major eye diseases. In diabetic retinopathy, AI algorithms analyze retinal images to accurately identify lesions, which helps clinicians in ophthalmology practice. Systems like IDx-DR (IDx Technologies Inc, USA) are FDA-approved for autonomous detection of referable diabetic retinopathy. For glaucoma, deep learning models assess optic nerve head morphology in fundus photographs to detect damage. In age-related macular degeneration, AI can quantify drusen and diagnose disease severity from both color fundus and optical coherence tomography images. AI has also been used in screening for retinopathy of prematurity, keratoconus, and dry eye disease. Beyond screening, AI can aid treatment decisions by forecasting disease progression and anti-VEGF response. However, potential limitations such as the quality and diversity of training data, lack of rigorous clinical validation, and challenges in regulatory approval and clinician trust must be addressed for the widespread adoption of AI. Two other significant hurdles include the integration of AI into existing clinical workflows and ensuring transparency in AI decision-making processes. With continued research to address these limitations, AI promises to enable earlier diagnosis, optimized resource allocation, personalized treatment, and improved patient outcomes. Besides, synergistic human-AI systems could set a new standard for evidence-based, precise ophthalmic care.

A Study on the Recognition and Treatment Rate of the Three Major Eye Diseases

A Study on the Recognition and Treatment Rate of the Three Major Eye Diseases

FQ-UWF: Unpaired Generative Image Enhancement for Fundus Quality Ultra-Widefield Retinal Images.

Ultra-widefield (UWF) retinal imaging stands as a pivotal modality for detecting major eye diseases such as diabetic retinopathy and retinal detachment. However, UWF exhibits a well-documented limitation in terms of low resolution and artifacts in the macular area, thereby constraining its clinical diagnostic accuracy, particularly for macular diseases like age-related macular degeneration. Conventional supervised super-resolution techniques aim to address this limitation by enhancing the resolution of the macular region through the utilization of meticulously paired and aligned fundus image ground truths. However, obtaining such refined paired ground truths is a formidable challenge. To tackle this issue, we propose an unpaired, degradation-aware, super-resolution technique for enhancing UWF retinal images. Our approach leverages recent advancements in deep learning: specifically, by employing generative adversarial networks and attention mechanisms. Notably, our method excels at enhancing and super-resolving UWF images without relying on paired, clean ground truths. Through extensive experimentation and evaluation, we demonstrate that our approach not only produces visually pleasing results but also establishes state-of-the-art performance in enhancing and super-resolving UWF retinal images. We anticipate that our method will contribute to improving the accuracy of clinical assessments and treatments, ultimately leading to better patient outcomes.

ROS-responsive celastrol-nanomedicine alleviates inflammation for dry eye disease

Dry eye disease (DED) is a major global eye disease leading to severe eye discomfort and even vision impairment. The incidence of DED has been gradually increasing with the high frequency of use of electronic devices. It has been demonstrated that celastrol (Cel) has excellent therapeutic efficacy in ocular disorders. However, the poor water solubility and short half-life of Cel limit its further therapeutic applications. In this work, a reactive oxygen species (ROS) sensitive polymeric micelle was fabricated for Cel delivery. The micelles improve the solubility of Cel, and the resulting Cel loaded micelles exhibit an enhanced intervention effect for DED. The in vitro results demonstrated that Cel-nanomedicine had a marked ROS responsive release behavior. The results of in vitro and in vivo experiments demonstrated that Cel has excellent biological activities to alleviate inflammation in DED by inhibiting TLR4 signaling activation and reducing pro-inflammatory cytokine expression. Therefore, the Cel nanomedicine can effectively eliminate ocular inflammation, promote corneal epithelial repair, and restore the number of goblet cells and tear secretion, providing a new option for the treatment of DED.

Sustained release of brimonidine from conjunctival sac insert to reduce intraocular pressure for glaucoma treatment

ABSTRACT Background Glaucoma is one of the major irreversible blinding eye diseases in the world. Reducing intraocular pressure (IOP) is the primary treatment option, and taking eye drops daily is the common method. However, short drug duration and poor bioavailability of eye drops may lead to unsatisfied therapeutic effects and inadequate patient compliance. Methods A brimonidine-loaded silicone rubber insert (BRI@SR@PT) was prepared by loading brimonidine into a surface-modified silicone rubber ring, followed by polydopamine/thermoplastic polyurethane coatings. The physical properties, in vitro cytocompatibility and drug release of BRI@SR@PT were investigated. The BRI@SR@PT was administrated in the conjunctival sac of rabbit eyes, and its in vivo drug release, IOP-lowering efficacy and biosafety were assessed. Results The BRI@SR@PT presented great thermal stability and excellent elasticity. The BRI@SR@PT was able to release BRI sustainably for 28 days with little toxicity in vitro. Compared to BRI eye drops, the BRI@SR@PT effectively lowered IOP for 21 days based on the sustained BRI release with great biosafety when administrated in conjunctival sac of rabbit eyes in a noninvasive fashion. Conclusions The conjunctival sac insert (BRI@SR@PT), as a promising drug-delivery platform, may provide a sustained IOP-lowering treatment for patients with ocular hypertension or glaucoma, without the need for invasive procedures.

Association of RASGRP1 polymorphism with vascular complications in Chinese diabetic patients with glycemic control and antihypertensive treatment

BackgroundStudies have shown that RASGRP1 was potently associated with the onset of type 2 diabetes mellitus (T2DM), and RASGRP1 rs7403531 was significantly correlated with islet function in T2DM patients. However, the effect of RASGRP1 polymorphism on blood glucose and blood pressure in T2DM patients after continuous treatment has yet to be fully elucidated.ObjectiveThis study aimed to explore the association between RASGRP1 genetic polymorphism and cardiovascular complications in T2DM patients, so as to provide more evidence for the individualized treatment of T2DM patients.MethodsWe retrospectively analyzed a large-scale multicenter drug clinical study cohort that based on a 2 × 2 factorial (glucose control axis and blood pressure lowering axis) randomized controlled design, with follow-up for 5 years. The major vascular endpoint events included cardiovascular death, non-fatal stroke, coronary heart disease, new-onset or worsening renal disease, and diabetic retinopathy. RASGRP1 rs12593201, rs56254815 and rs7403531 were finally selected as candidate single nucleotide polymorphisms. Mixed linear model and Cox hazard ratio (HR) model were used for data analysis with IBM SPSS (version 20.0 for windows; Chicago, IL).ResultsOur study enrolled 1357 patients with high-risk diabetes, with a mean follow-up duration of 4.8 years. RASGRP1 rs7403531 was associated with vascular events in hypoglycemic and antihypertensive therapy. Specifically, compared with CC carriers, patients with CT/TT genotype had fewer major microvascular events (HR = 0.41, 95% confidence interval (CI) 0.21–0.80, P = 0.009), and reduced the risk of major eye disease events (HR = 0.44, 95% CI 0.20–0.94, P = 0.03). For glucose lowering axis, CT/TT carriers had a lower risk of secondary nephropathy (HR = 0.48, 95% CI 0.25–0.92, P = 0.03) in patients with standard glycemic control. For blood pressure lowering axis, all cerebrovascular events (HR = 2.24, 95% CI 1.11–4.51, P = 0.025) and stroke events (HR = 2.07, 95% CI 1.03–4.15, P = 0.04) were increased in patients with CC genotype compared to those with CT/TT genotype in the placebo group, respectively. Furthermore, patients with CC genotype showed a reduced risk of major cerebrovascular events in antihypertensive group (HR = 0.36, 95% CI 0.15–0.86, P = 0.021). For RASGRP1 rs56254815, compared with the AA genotype carriers, the systolic blood pressure of AG/GG carriers in the antihypertensive group decreased by 1.5mmhg on average (P = 0.04). In the placebo group, the blood pressure of AG/GG carriers was 1.7mmHg higher than that of AA carriers (P = 0.02).ConclusionWe found that patients with G allele of RASGRP1 (rs56254815) showed a better antihypertensive therapy efficacy in T2DM patients. The rs7403531 T allele could reduce the risk of major microvascular events and major eye diseases in T2DM patients receiving either hypoglycemic or antihypertensive therapy. Our findings suggest that RASGRP1 genetic polymorphism might predict the cardiovascular complications in T2DM patients.

Susceptibility to eye diseases in relation to age and kidney failure among Taiwanese adults.

The kidney and eyes share common pathways and are thought to be closely connected. Chronic kidney disease and major eye diseases, such as cataract and glaucoma, are strongly associated with age. However, further investigation is needed to understand the joint impact of age and kidney diseases on eye diseases. In this study, we assessed the risk of eye diseases in relation to age and kidney failure in Taiwanese adults. Our study included 127,561 cancer-free volunteers aged 30 to 70 years who participated in the Taiwan Biobank (TWB) project from 2008 to 2020. Information on the main exposures (kidney failure and age) and the outcome (eye diseases, including glaucoma, cataract, xerophthalmia, and retinal detachment) was collected through questionnaires. In general, kidney failure and older age were independently associated with a higher risk of eye, particularly cataract and retinal detachment: prevalence odds ratio (POR); 95% confidence interval (CI) = 2.480; 1.635-3.761 for cataract and 3.885; 1.968-7.666 for retinal detachment. A significant interaction between kidney failure and age on cataract was observed (p-value = 0.0002). Age-stratified analysis revealed a higher risk of cataract among patients with kidney failure aged below 50 (POR = 6.534; 95% CI = 2.493-17.124) and between 50 and 60 years (POR = 3.957; 95%CI = 1.986-7.881). Combining kidney failure and age (reference: no kidney failure and age < 50 years), kidney failure in all age groups was associated with a higher risk of cataract. The PORs; 95% CIs were 10.725; 4.227-27.211 for patients below 50 years, 28.487; 14.270-56.866 for those aged 50-60 years, and 43.183; 24.434-72.824 for those > 60 years. Combining cataract and age (reference: no cataract and age < 50 years), patients below 50 years had the highest risk of kidney failure (POR; 95% CI = 9.510; 3.722-24.297). Our study suggests that age and kidney failure may jointly contribute to eye diseases, particularly cataract. The association between cataract and kidney failure could be bidirectional, especially in individuals below 50 years. This significant bidirectional relationship underscores the need for screening patients with cataract for kidney failure and vice versa, particularly in younger adults.

You Are What You Eat: Preventive Roles of Antioxidant Phytochemicals on Age-related Eye Diseases

Aim: What we eat plays a vital role in human health with no exception to the eye which results to either good or poor vision. This review aimed at determining how what we eat affect age-related eye diseases and the role of antioxidants in phytochemical compound in preventing age-related eye diseases.&#x0D; Study Design: A non-systematic review and evaluation of published literatures was done through web search engines such as PubMed and Google Scholar using Mendeley reference library for citation.&#x0D; Methodology: A total of 48 articles were reviewed using the key words such as ‘’you are what you eat,’’ Age-related eye diseases, Antioxidants, Phytochemical compounds, Oxidative Stress and Free Radicals&#x0D; Results: Increased consumption of energy-dense foods such as refined grains, processed meats, added sugar and saturated fatty foods might increase the risk of obesity, insulin resistance, chronically elevated blood glucose, chronic systemic inflammation, oxidative stress, and increased protein damage leading to initiation and progression of systemic diseases such as diabetes, hypertension, heart related diseases, as well as age-related eye diseases such as cataract, glaucoma, diabetic retinopathy, and macular degeneration. Findings also showed that many botanical compounds such as curcumin, lutein and zeaxanthin, ginseng, and many more, present in food exhibit strong antioxidative, anti-inflammatory, and antiapoptotic properties that helps in ameliorating the destructive roles of oxidative stress.&#x0D; Conclusion: Phytochemicals with proven antioxidant and anti-inflammatory activities, such as carotenoids and polyphenols, could be of benefit in preventing age-related eye diseases. Consumption of products containing these phytochemicals is recommended to provide noninvasive alternatives for protection, prevention and treatments of the major systemic and age-related eye diseases.

Mutational analysis of CRYAA gene of cataract and investigating risk assessment factors responsible for eye diseases in district buner, KPK, Pakistan.

This research has been designed to analyze the risk factors of major eye diseases and the genetic alterations contributing to the manifestation of such disease. For this purpose, data was collected from 256 patients diagnosed by an ophthalmologist by using a specialized questionnaire. Blood samples were collected from 100 patients to perform a genetic investigation of cataracts. Whole genomic DNA was extracted from blood samples via the phenol-chloroform method. The purified DNA was used as the template for the amplification of about 400 bp fragments amplifying exons 1 and 2 of the CRYAA gene. The statistical analysis showed that 68% of individuals were blind due to cataracts. During molecular analysis, nucleotide sequences obtained have resulted in one silent mutation that occured at 20 positions in exon 2. It was replacing A>G which in turn substitutes the Lysine at position 70 for Arginine. It was interpreted by statistical analysis that this mutation did not result in a significant change in the CRYAA gene. In addition, protein analysis showed no significant changes in the structure of normal and mutated genes. At last, it is concluded that environmental risk factors play a major role in the studied diseases as compared to genetic factors. It is recommended to extend the study to a larger population to study all exons of the CRYAA gene as well as develop better estimates of the magnitude of the problems of visual loss and eye diseases in the Pakistani population.

Diffuse Damage in Traumatic Brain Injury and Its Large-Spectrum Implications: Keys on Diffuse Axonal Injury and Indirect Traumatic Optic Neuropathy for Major Eye Diseases. Revisiting the “Eye-Brain Axis”

Diffuse damage is a key characteristic of alpha emitters when they cause internal contamination, because their alpha charge keeps them away from each other, giving birth to “grid” patterns in the brain. The effect was already shown to be characteristic of traumatic brain injury. The push effect of the positive charges onto other positive charges (reverse magnet effect) leads to many comorbidities altogether with the main disease caused by them, beyond TBI. The study of the “eye-brain axis” is a large provider of cases of such comorbidities. The review of eye diseases and their relation with TBI or related diseases, especially thyroid diseases, was done to determine whether they are related or not to this grid effect. The results show that more diseases than what was known until now are found to be dependent on contamination with alpha emitters.

Trends in the Diagnosed Prevalence and Incidence of Major Eye Diseases in Medicare Part B Fee-for-Service Beneficiaries 68 Years of Age or Older

To study contemporary trends in the diagnosed prevalence and incidence of age-related eye diseases among Medicare Fee-for-Service (FFS) beneficiaries. Analysis of Medicare administrative claims data. Medicare FFS beneficiaries 68 years of age and older from 2005 through 2020 who were enrolled continuously in both Part A and Part B for 3 years, including the index year and a 2-year lookback period. Annual cross-sectional diagnosed prevalence and incidence rates were calculated. Age standardization was performed using the direct standardization method to account for changes in the age structure of the study population. Rates stratified by demographics (age, sex, race, and ethnicity) also were calculated. Annual prevalence and incidence of diagnosed age-related macular degeneration (AMD), diabetic retinopathy (DR) (among those with diabetes), and glaucoma. At baseline, in 2005, 60% of included beneficiaries were female, 20% were 85 years of age or older, 86% were non-Hispanic White, and one-quarter had a diagnosis of diabetes. From 2005 through 2019, the prevalence of a diagnosis of any of the conditions studied increased from 16.4% (n = 3 628 996) to 17.9% (n= 3 731 281). Diagnosed incidence decreased over this period from 4.9% (n = 954 878) in 2005 to 4.2% in 2019 (n=757 696). The diagnosed prevalence of AMD increased from 6.8% (n= 1 504 770) to 9.4% (n= 1 965 176); the diagnosed prevalence of any DR among those with diabetes decreased from 9.3% (n= 504 135) to 9.0% (n=532 859), although the diagnosed prevalence of vision-threatening DR increased from 2.0% to 3.4%; and the diagnosed prevalence of any diagnosed glaucoma decreased from 8.8% (n= 1 951 141) to 8.1% (n= 1 692 837). In 2020, the diagnosed prevalence and incidence of all diagnoses decreased. During the study period, we detected demographic differences in the prevalence and incidence of diagnosis of each condition. This study presents updated data on the prevalence and incidence of diagnosed major chronic, age-related eye diseases among Medicare FFS beneficiaries. Compared with older epidemiologic estimates, we found that the diagnosed prevalence of each condition studied was higher in more recent years. These findings may inform public health and policy planning and resource allocation to address the eye health of an increasingly older United States population. The author(s) have no proprietary or commercial interest in any materials discussed in this article.

A Study on the 3 Major Eye Diseases and Quality of Life

A Study on the 3 Major Eye Diseases and Quality of Life

Impact of major age-related eye disorders on health-related quality of life assessed by EQ-5D: a systematic review and meta-analysis.

This study is to quantitatively estimate the health-related quality of life (HRQOL) impact of major age-related eye diseases (AREDs) including cataract, glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy (DR) assessed by the EuroQoL Five-Dimensional Questionnaire (EQ-5D). PubMed, Embase, Cochrane Library, and CINAHL were searched until October 20, 2022. Studies were included if they reported the EQ-5D health utility score (HUS) or visual analogue scale (VAS) score of both AREDs patients and healthy controls. The mean difference (MD) in HUS or VAS score between cases and controls and its 95% confidence interval (95%CI) were pooled using the random-effects model. We also performed sensitivity analysis using the leaving-one-out method and subgroup analyses by sample size and race. The prevalence in reporting any problems in the five EQ-5D dimensions was summarized and compared between cases and controls using the Chi-square test. Fifteen articles involving 30,491 participants were included in this review. Pooled estimates indicated reduced HUS in AMD patients (MD = -0.04, 95%CI -0.07, -0.01; P = 0.009), DR patients (MD = -0.03, 95%CI -0.05, -0.01; P = 0.01), and glaucoma patients (MD = -0.06, 95%CI -0.10, -0.01; P = 0.01), compared with the controls. Significantly lower EQ-5D VAS score was also observed in cataract patients (MD = -11.33, 95%CI -13.47, -9.18; P < 0.001) and DR patients (MD = -6.41, 95%CI -10.64, -2.18; P = 0.003). AREDs patients reported usual activities and anxiety/depression problems more frequently than the control group. Our findings confirmed the HRQOL impairment caused by major AREDs including AMD, cataract, DR, and glaucoma. High-quality studies with large sample sizes are warranted to further verify our results.

The experience of diabetic retinopathy patients during hospital-to-home full-cycle care: A qualitative study

BackgroundDiabetic retinopathy (DR) is one of the major blinding eye diseases worldwide. Psychological, emotional and social problems of DR patients are prominent. The aim of this study is to explore the experiences of patients with different phases of DR from hospital to home based on the “Timing It Right” framework, and to provide a reference for formulating corresponding intervention strategies.MethodsThe phenomenological method and semi-structured interviews were used in this study. A total of 40 patients with DR in different phases were recruited from a tertiary eye hospital between April and August 2022. Colaizzi’s analysis method was used to analyse the interview data.ResultsBased on the “Timing It Right” framework, different experiences in five phases of DR before and after Pars Plana Vitrectomy (PPV) were extracted. The patients experienced complicated emotional reactions and inadequate coping skills during the pre-surgery phase, increased uncertainty during the post-surgery phase, insufficient confidence and the decision to change during the discharge preparation phase, eagerness for professional support and moving forward in exploration during the discharge adjustment phase, and courageous acceptance and positive integration during the discharge adaptation phase.ConclusionThe experiences of DR patients with vitrectomy in different phases of disease are ever-changing, and medical staff should provide personalized support and guidance to help DR patients get through the hard times smoothly and enhance the quality of hospital-family holistic care.

Analysis of the epidemiological burden of age-related macular degeneration in China based on the data of global burden of disease.

Age-related macular degeneration (AMD) is one of the 3 major eye diseases recognized by WHO to prevent blindness, and which is the main cause of irreversible visual impairment in the elderly. This study aims to analyze the disease epidemiological burden, and provide a theoretical foundation for the prevention and control of AMD in China based on the data in global burden of disease (GBD) 2019. The prevalent cases/prevalence, disability-adjusted life year (DALYs)/DALY rate of AMD and socio-demographic index (SDI) for global and China were searched from the GBD 2019 database to analyze the epidemiological trend, age-period-gender trend of AMD in China from 1990 to 2019, and to evaluate the relations between the prevalence and SDI. In 2019, the prevalence of AMD in China was at a high level in the world, and the number of prevalent cases were 1.93 times of that in 1990. The prevalence and DALY rates continued to rise. The age trend of AMD in China was high at the middle of the age stages and low at the two ends, and which was higher in the female than in the male. With the increase of SDI, the prevalence of AMD was increased linearly. The disease burden of AMD in China is increased significantly and is positively correlated with the social development from 1990 to 2019. It is of great significance to study the relationship between epidemilolgical data of AMD and social development level for diagnosis treatment and policy of AMD.

AI telemedicine screening in ophthalmology: health economic considerations

AI telemedicine screening in ophthalmology: health economic considerations

Economic evaluation of combined population-based screening for multiple blindness-causing eye diseases in China: a cost-effectiveness analysis

More than 90% of vision impairment is avoidable. However, in China, a routine screening programme is currently unavailable in primary health care. With the dearth of economic evidence on screening programmes for multiple blindness-causing eye diseases, delivery options, and screening frequencies, we aimed to evaluate the costs and benefits of a population-based screening programme for multiple eye diseases in China. We developed a decision-analytic Markov model for a cohort of individuals aged 50 years and older with a total of 30 1-year cycles. We calculated the cost-effectiveness and cost-utility of screening programmes for multiple major blindness-causing eye diseases in China, including age-related macular degeneration, glaucoma, diabetic retinopathy, cataracts, and pathological myopia, from a societal perspective (including direct and indirect costs). We analysed rural and urban settings separately by different screening delivery options (non-telemedicine [ie, face-to-face] screening, artificial intelligence [AI] telemedicine screening, and non-AI telemedicine screening) and frequencies. We calculated incremental cost-utility ratios (ICURs) using quality-adjusted life-years and incremental cost-effectiveness ratios (ICERs) in terms of the cost per blindness year avoided. One-way deterministic and simulated probabilistic sensitivity analyses were used to assess the robustness of the main outcomes. Compared with no screening, non-telemedicine combined screening of multiple eye diseases satisfied the criterion for a highly cost-effective health intervention, with an ICUR of US$2494 (95% CI 1130 to 2716) and an ICER of $12 487 (8773 to 18 791) in rural settings. In urban areas, the ICUR was $624 (395 to 907), and the ICER was $7251 (4238 to 13 501). Non-AI telemedicine screening could result in fewer costs and greater gains in health benefits (ICUR $2326 [1064 to 2538] and ICER $11 766 [8200 to 18 000] in rural settings; ICUR $581 [368 to 864] and ICER $6920 [3926 to 13 231] in urban settings). AI telemedicine screening dominated no screening in rural settings, and in urban settings the ICUR was $244 (-315 to 1073) and the ICER was $2567 (-4111 to 15 389). Sensitivity analyses showed all results to be robust. By further comparison, annual AI telemedicine screening was the most cost-effective strategy in both rural and urban areas. Combined screening of multiple eye diseases is cost-effective in both rural and urban China. AI coupled with teleophthalmology presents an opportunity to promote equity in eye health. National Natural Science Foundation of China.

Therapeutic Role of Curcumin, a Traditional Indian Remedy in Various Ocular Disorders

Curcumin (diferuloylmethane) derived from the rhizome of Curcuma longa L. has been an active ingredient of traditional Chinese medicine and Ayurvedic medicine for thousands of years to treat liver diseases, rheumatoid diseases, diabetes, atherosclerosis, infectious diseases and cancer. Curcumin has multiple essential pharmacological properties namely, antioxidant, anti-inflammatory, antimutagenic, antimicrobial and anticancer activity. Curcumin inhibits oxidative stress, angiogenesis and inflammatory processes and restore body homeostasis. Its effectiveness was also proved for major eye diseases. In this article, the influence of curcumin on various eye diseases such as dry eye disease, conjunctivitis, pterygium, anterior uveitis, glaucoma, cataract, age-related macular degeneration, diabetic retinopathy, corneal neovascularization, corneal wound healing are reported. Data analysis from several clinical and preclinical investigations indicate that curcumin is highly effective as a therapeutic agent in the treatment of various eye disorders.

IPSC-based model of Vogt-Koyanagi-Harada disease for phenotype recapitulation and drug screening

Vogt-Koyanagi-Harada (VKH) disease, a major blinding eye disease, is characterized by an autoimmune response against melanocytes in multiple organs throughout the body. Currently, the aetiology and pathogenesis of VKH disease are unclear, and the treatment strategy needs to be further optimized. The retinal pigment epithelium (RPE), a monolayer of pigmented cells of the fundus, is essential for maintaining normal visual function and is involved in both the acute and chronic stages of VKH disease. Therefore, the functions of the RPE may play a critical role in the aetiology and treatment of VKH disease. Herein, we established a human induced pluripotent stem cell (hiPSC) RPE model of VKH disease by reprogramming peripheral blood mononuclear cells (PBMCs) into iPSCs and then differentiating them into RPE cells. Patient-derived RPE cells exhibited barrier disruption, impaired phagocytosis, and depigmentation compared with those from normal controls, which was consistent with the features of VKH disease. Furthermore, a small molecular compound targeting EGR2 was found to rescue the barrier and phagocytic functions of the hiPSC-RPE cells through high-throughput virtual screening and functional studies, suggesting a promising strategy for the treatment of VKH disease.

Fixed combination of dorzolamide / timolol eye drops versus fixed combination of brinzolamide / timolol eye drops in the treatment of primary open angle glaucoma and ocular hypertension

Background: Glaucoma is a worldwide major blinding eye disease. Medical treatment aims at reduction of intraocular pressure (IOP) to prevent further damage to the optic nerve. Dorzolamide 2.0% + timolol 0.5% (D / T - FC) (Cosopt®) and brinzolamide 1.0% + timolol 0.5% (B / T - FC) (Azarga®) are both types of commercially available fixed dose combination eye drops that are used to treat primary open angle glaucoma (POAG) and ocular hypertension (OHT). Dorzolamide and brinzolamide are topical carbonic anhydrase inhibitors (CAIs) fixed combined with timolol a beta-adrenoceptor blocker. CAIs and beta blockers reduce IOP through inhibiting the production of aqueous humor by the ciliary epithelium.Aim: The aim of this prospective clinical therapeutic study was to compare the efficacy and side effects of both combinations in POAG and OHT.Patients &amp; methods: 50 cases of POAG / OHT were enrolled in this study. The patients were randomly assigned to 2 groups with 25 patients in each group. Group 1 received D / T - FC eye drops twice daily while group 2 received B / T - FC eye drops twice daily. Baseline IOP was measured and recorded and then followed up at regular intervals of 2 weeks for one month then monthly for 6 months and then the percentage of reduction was determined. The side effects questioned and reported by the patients were recorded.Results: Both groups had a statistically significant reduction in IOP from baseline (P=0.0001). In the first group IOP reduction ranged from 7.0 to 12.0 mmHg (21.9 – 37.5 %) while in group 2 IOP reduction ranged from 6.5 to 11.0 mm Hg (20.7 – 37.9 %). No significant difference existed between the 2 groups (P=0.6075). Group 2 reported less adverse effects than group 1 (P=0.0412).Conclusion: Both combinations were equally effective in reducing IOP in glaucoma and OHT patients, however B / T - FC was more tolerated.