Activation of dopamine D2 receptor is critical for the development of form-deprivation myopia in the C57BL/6 mouse.
Huang Furong,Yan Tingting,Shi Fanjun,An Jianhong,Xie Ruozhong,Zheng Fan,Li Yuan,Chen Jiangfan,Qu Jia,Zhou Xiangtian
Investigative ophthalmology & visual science
PURPOSE:This study used dopamine D2 receptor (D2R) knockout (KO) mice to investigate the role of D2R activity in the development of form-deprivation myopia (FDM). Sulpiride, a D2R antagonist, was administered systemically into wild-type (WT) mice to validate the involvement of D2R in FDM development. METHODS:The D2R KO and WT C57BL/6 mice were subjected to FDM. Wild-type mice received daily intraperitoneal injections of sulpiride, 8 μg/g body weight, for a period of 4 weeks. The body weight, refraction, corneal radius of curvature, and ocular axial components were measured at week 4 of the experiment. Differences in all ocular parameters between the experimental and control groups were compared statistically. RESULTS:Form-deprivation myopia in D2R KO mice (FD-KO) was significantly reduced compared with their WT littermates (interocular difference, -2.12 ± 0.91 diopter [D] in FD-KO versus -5.35 ± 0.83 D in FD-WT, P = 0.014), with a smaller vitreous chamber depth (0.008 ± 0.006 vs. 0.026 ± 0.006 mm, P = 0.044) and axial length (-0.001 ± 0.007 vs. 0.027 ± 0.008 mm, P = 0.007). Furthermore, FDM was attenuated in animals treated with sulpiride (-2.01 ± 0.31 D in FD-sulpiride versus -4.06 ± 0.30 D in FD-DMSO, P < 0.001) compared with those treated with vehicle, with a retardation in growth of vitreous chamber depth (-0.001 ± 0.006 vs. 0.022 ± 0.004 mm, P = 0.003) and axial length (-0.004 ± 0.007 vs. 0.027 ± 0.005 mm, P = 0.001). CONCLUSIONS:Genetic and pharmacological inactivation of D2R attenuates FDM development in mice, suggesting that dopamine acting on D2R appears to promote the development of FDM in C57BL/6 mice. Further studies are required to confirm these results using animal models in which retinal D2R is selectively blocked.
10.1167/iovs.13-13211
Short-Term Deposition of PM Particles on Contact Lens Surfaces: Effect on Oxygen Permeability and Refractive Index.
Dong Zhizhang,Ding Xiaoyan,Li Yong,Gan Yifeng,Wang Yanhui,Xu Libin,Wang Yahong,Zhou Ying,Li Juan
Current eye research
PURPOSES:To identify the deposition of fine (≤2.5 μm diameter) particulate matter (PM) particles (PM) on contact lens surfaces and to investigate the effects of such deposition on the oxygen permeability (OP) and refractive index (RI) of contact lenses. METHODS:A total of 36 contact lenses, including rigid gas permeable (RGP) lens and soft contact lens (SCL), were investigated. RGP lens (n=12) and SCL (n=12) (experimental group) were incubated in a PM solution for 24 h, after which PM-treated RGP lens (n=6) and SCL (n=6) were further washed for 1 h in phosphate-buffered saline (PBS). All lenses were examined by field emission scanning electron microscopy. OP and RI of all lenses were measured. RESULTS:Average-sized PM particles deposited on RGP contact lens and SCL surfaces after immersion in the PM solution were 3.192 ± 1.637 and 2.158 ± 1.187/100 μm, respectively. On RGP lens surfaces, we observed both large (≥2.5 µm diameter) and small (PM) particles. PM particles were deposited in diffuse patterns, primarily along the honeycomb structural border of SCL, while no PM particles were found in the honeycomb hole of SCL surfaces. Washing in PBS removed the larger PM particles from RGP lens surfaces, but left copious amounts of PM particles. In contrast, nearly all PM particles were removed from SCL surfaces after PBS washing. OP values of RGP lens and SCL appeared to be unchanged by PM deposition. RI values increased in both RGP lens and SCL groups after PM deposition. However, these increases were not statistically significant, suggesting that PM deposition itself does not cause fluctuations in contact lens RI. CONCLUSIONS:Deposition of PM particles on contact lens surfaces varies according to lens material. PM particles deposited on SCL, but only large particles on RGP surfaces were able to be removed by washing in PBS and did not appear to alter OP and RI of either lens type.
10.1080/02713683.2018.1476552
Differences in children and adolescents' ability of reporting two CVS-related visual problems.
Hu Liang,Yan Zheng,Ye Tiantian,Lu Fan,Xu Peng,Chen Hao
Ergonomics
The present study examined whether children and adolescents can correctly report dry eyes and blurred distance vision, two visual problems associated with computer vision syndrome. Participants are 913 children and adolescents aged 6-17. They were asked to report their visual problems, including dry eyes and blurred distance vision, and received an eye examination, including tear film break-up time (TFBUT) and visual acuity (VA). Inconsistency was found between participants' reports of dry eyes and TFBUT results among all 913 participants as well as for all of four subgroups. In contrast, consistency was found between participants' reports of blurred distance vision and VA results among 873 participants who had never worn glasses as well as for the four subgroups. It was concluded that children and adolescents are unable to report dry eyes correctly; however, they are able to report blurred distance vision correctly. Three practical implications of the findings were discussed. PRACTITIONER SUMMARY:Little is known about children's ability to report their visual problems, an issue critical to diagnosis and treatment of children's computer vision syndrome. This study compared children's self-reports and clinic examination results and found children can correctly report blurred distance vision but not dry eyes.
10.1080/00140139.2013.819939
Precision of a new Scheimpflug and Placido-disk analyzer in measuring corneal thickness and agreement with ultrasound pachymetry.
Huang Jinhai,Savini Giacomo,Hu Liang,Hoffer Kenneth J,Lu Weicong,Feng Yifan,Yang Feng,Hu Xiuli,Wang Qinmei
Journal of cataract and refractive surgery
PURPOSE:To assess the precision of corneal thickness measurements obtained by a new Scheimpflug camera combined with Placido-disk corneal topography (Sirius) and compare the measured values with those obtained by ultrasound (US) pachymetry. SETTING:Eye Hospital of Wenzhou Medical College, Wenzhou, China. DESIGN:Comparative evaluation of a diagnostic test or technology. METHODS:Eyes of healthy subjects were examined with the Scheimpflug-Placido topographer. Central (CCT) and thinnest (TCT) corneal thickness were recorded after 3 consecutive measurements. For US pachymetry, only CCT was measured. Measurements were repeated within 1 week. The within-subject standard deviation (S(w)), test-retest repeatability, coefficient of variation (CoV), and intraclass correlation coefficient (ICC) were calculated to evaluate intrasession repeatability and intersession reproducibility. Interdevice comparison was analyzed with paired t tests and Bland-Altman plots. RESULTS:The intrasession repeatability of Scheimpflug-Placido measurements was high, with test-retest and CoV close to 9 μm and 0.6% for CCT and TCT, respectively. The intersession test-retest and CoV were close to 10 μm and 0.7%, respectively. The ICC was higher than 0.98 for repeatability and reproducibility. High agreement was found between Scheimpflug-Placido and US pachymetry measurements, with narrow 95% limits of agreement. CONCLUSIONS:The Scheimpflug-Placido instrument showed excellent intrasession repeatability and intersession reproducibility of CCT and TCT measurements in healthy eyes. High agreement and lack of statistically significant difference suggest that the instrument's TCT and the US pachymetry-CCT measurements can be used interchangeably in subjects with normal corneal thickness. FINANCIAL DISCLOSURE:No author has a financial or proprietary interest in any material or method mentioned.
10.1016/j.jcrs.2012.10.034
[Myopia prevalence and influencing factor analysis of primary and middle school students in our country].
Xie Hong-Li,Xie Zuo-Kai,Zhou Fen,Hu Liang
Zhonghua yi xue za zhi
OBJECTIVES:To explore the situation and the affect factors of myopia and scientificalness and effectiveness of eye exercises about primary and middle school students. METHODS:Through the random cluster sampling method, 20 000 students of 90 schools including key and non-key primary or junior or senior school in country and city of shandong, qinghai, yunnan, Shanghai and wenzhou were random selected. Primary students is 11 246 junior students is 3673 senior students is 4220.We surveyed related situation of eye exercises, myopia. a total of 19 139 valid questionnaires were received. By random sampling stratification method, freshmen were selected and retrospective surveyed. 929 freshmen have normal vision when they graduated primary school. 338 freshmen have normal vision when they graduated primary school.2 groups are considered analysis object, and Myopic students of the former in junior school stages and the latter in senior school stages are considered case group, normal vision are considered control group, and then through the Logistic multiple stepwise regression analysis, a regression analysis model is established. RESULTS:This survey show that myopia prevalence was 13.7% of primary students, 42.9% of junior students, 69.7% of senior students. According to the significant P < 0.001, Rsquare = 0.14, the result shows that the model has the significant statistical significance. Among the influence factors, whether to long-term excessive use eye is the most significant, and following by outdoor activities and gender. A chi-square test χ(2) = 0.371 and P = 0.543 show that doing eye exercises was not statistically significant to prevalence of myopia. CONCLUSION:The influence factors are changed, and the preventive methods should be adjusted with the social environment.
Evaluation of corneal thickness using a Scheimpflug-Placido disk corneal analyzer and comparison with ultrasound pachymetry in eyes after laser in situ keratomileusis.
Huang Jinhai,Lu Weicong,Savini Giacomo,Hu Liang,Pan Chao,Wang Jing,Tan Weina,Chen Jia,Wang Qinmei
Journal of cataract and refractive surgery
PURPOSE:To evaluate the repeatability and reproducibility of corneal thickness measurements in post-laser in situ keratomileusis (LASIK) eyes using a rotating Scheimpflug camera combined with a Placido disk corneal topographer (Sirius) and compare the results with those of ultrasound (US) pachymetry. SETTING:Eye Hospital of Wenzhou Medical College, Wenzhou, China. DESIGN:Comparative evaluation of a diagnostic test or technology. METHODS:Patients were examined 3 times with the Scheimpflug-Placido topographer by 2 examiners. The central pupil corneal thickness (CTpupil), apical corneal thickness (CTapex), and thinnest corneal thickness (CTthinnest) were recorded. After noncontact examinations, US pachymetry was used to obtain the central corneal thickness (CCT). RESULTS:The Scheimpflug-Placido topographer showed high intraoperator repeatability as indicated by a test-retest repeatability of less than 8.5 μm for CTpupil, CTapex, and CTthinnest, The coefficients of variation (CoV) were less than 0.7%, and the intraclass correlation coefficient was higher than 0.99. Excellent results were also obtained for interoperator reproducibility. All CoVs were less than 0.5%. The 95% limits of agreement between the Scheimpflug-Placido measurement and the US pachymetry measurements were narrow (-16.62 to 12.44 μm for CTpupil versus US pachymetry CCT; -17.49 to 12.16 μm for CTapex versus US pachymetry CCT; -18.59 to 10.90 μm for CTthinnest versus US pachymetry CCT). CONCLUSIONS:The Scheimpflug-Placido topographer showed excellent intraoperator repeatability and interoperator reproducibility of CTpupil, CTapex, and CTthinnest measurements in post-LASIK eyes. The CCT measurements obtained using the device were in high agreement with those obtained by US pachymetry, suggesting that the 2 devices are interchangeable. FINANCIAL DISCLOSURE:No author has a financial or proprietary interest in any material or method mentioned.
10.1016/j.jcrs.2013.01.038
The influence of intraocular pressure on wavefront aberrations in patients undergoing laser-assisted in situ keratomileusis.
Hu Liang,Wang Qinmei,Yu Peng,Yu Ye,Zhang Dong,He Ji C,Lu Fan
Investigative ophthalmology & visual science
PURPOSE:To investigate the effect of intraocular pressure (IOP) on wavefront aberrations in the anterior cornea, the internal optics, and the whole eye for myopic patients undergoing laser-assisted in situ keratomileusis (LASIK) surgery. METHODS:Fifty-seven myopic subjects were tested for wavefront aberrations in the anterior corneal surface and the whole eye using a corneal topographer and a wavefront analyzer, respectively, pre- and post-LASIK. The IOP and central corneal thickness (CCT) were measured with a noncontact tonometer and a pachymeter, respectively. Pre- and postoperative wavefront aberrations were compared, and the correlation between changes in the Zernike aberrations and the IOP was statistically tested. RESULTS:The mean root mean square (RMS) values of the higher-order aberrations (HOAs) were significantly increased in the anterior cornea, the internal optics, and the whole eye. The mean RMS values for a majority of Zernike terms were significantly increased, and systematic increases in the spherical aberrations were found in both the cornea and the whole eye. The spherical aberrations after LASIK were significantly correlated to the IOP (r = 0.59, P < 0.01, for oculus dexter [OD, right eye] and r = 0.49, P < 0.01, for oculus sinister [OS, left eye] in the cornea; r = 0.38, P < 0.01, for OD and r = 0.46, P < 0.01, for OS in the whole eye). CONCLUSIONS:IOP contributes to LASIK-induced HOAs, particularly spherical aberrations. To control the HOAs after LASIK, a new algorithm should include the IOP as a variable for laser surgery.
10.1167/iovs.12-11349
Tear menisci after laser in situ keratomileusis with mechanical microkeratome and femtosecond laser.
Xie Wenjia,Zhang Dong,Chen Jia,Liu Jing,Yu Ye,Hu Liang
Investigative ophthalmology & visual science
PURPOSE:To investigate the effect on tear menisci after laser in situ keratomileusis (LASIK) with flap creation by either microkeratome or femtosecond laser. METHODS:Sixty eyes of 30 myopes were analyzed. Fifteen patients underwent LASIK with Moria II microkeratome, and the other 15 patients with 60-KHz IntraLase femtosecond laser. Upper and lower tear meniscus parameters of height (UTMH, LTMH) and area (UTMA, LTMA) were measured by SD-OCT preoperatively and 1 week, 1 month, and 3 months postoperatively. RESULTS:Compared with the baseline values, all tear meniscus parameters decreased significantly at each postoperative time point (all P < 0.01) in both groups. LTMH increased significantly between 1 week and 1 month and between 1 and 3 months after surgery in the microkeratome (both P < 0.01) and femtosecond laser groups (P < 0.01, P = 0.012, respectively). There were significant increases in LTMA between 1 week and 1 month after surgery in the microkeratome group (P < 0.01) and in the femtosecond laser group (P = 0.028). There were no significant differences in UTMH, UTMA, LTMH, or LTMA between two groups. The depth of ablation was negatively correlated with the LTMA at 1 week after surgery (R = -0.256, P = 0.049) for all patients. CONCLUSIONS:There were no significant differences in the tear meniscus parameters between the microkeratome and femtosecond laser groups. The depth of ablation was significantly correlated with the LTMA only at 1 week after surgery.
10.1167/iovs.13-13669
Tear menisci and corneal subbasal nerve density in patients after laser in situ keratomileusis.
Hu Liang,Xie Wenjia,Liu Jing,Zhou Yang,Zhou Qimin,Yu Ye,Chen Jia,Lu Fan
Eye & contact lens
OBJECTIVE:To investigate the relationship between tear menisci and corneal nerve density in patients after laser in situ keratomileusis (LASIK). METHODS:Twenty-eight eyes of 14 myopic patients were enrolled. Height and area of the upper and lower tear menisci--upper tear meniscus height, upper tear meniscus area, lower tear meniscus height (LTMH), and lower tear meniscus area (LTMA)--were measured by spectral domain optical coherence tomography before surgery, 1 week, 1 month, and 3 months after surgery. Central, temporal, and nasal corneal nerve densities were measured by confocal microscopy before surgery, 1 month, and 3 months after surgery. RESULTS:After surgery, LTMH and LTMA increased significantly from 1 week to 1 month (P=0.009 and =0.011, respectively) and 1 month to 3 months (P=0.003 and =0.039, respectively); temporal and nasal nerve densities increased significantly from 1 month to 3 months (P<0.001, P=0.016, respectively). Lower tear meniscus area was significantly correlated with central and nasal nerve densities at 1 month (R=0.478 and 0.46, P=0.01 and 0.014, respectively), whereas LTMH and LTMA at 3 months were significantly correlated with central nerve density at 1 month (R=0.449 and 0.608, P=0.017 and 0.001, respectively). CONCLUSIONS:Lower tear menisci and peripheral corneal nerves recovered continually after LASIK during the early stage. However, tear volume might depend on residual central corneal nerves at 1 month, rather than on corneal nerve recovery.
10.1097/ICL.0000000000000062
[Corneal subbasal nerve density changes after laser in situ keratomileusis with mechanical microkeratome and femtosecond laser].
Hu Liang,Xie Wenjia,Tang Lei,Chen Jia,Zhang Dong,Yu Peng,Qu Jia
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology
OBJECTIVE:To compare the corneal subbasal nerve density (SND) changes after laser in situ keratomileusis (LASIK) with a microkeratome and a femtosecond laser. METHODS:Prospective clinical study. Sixty eyes of thirty myopes were included. Fifteen patients (30 eyes) underwent LASIK with the Moria II microkeratome, and the other 15 patients (30 eyes) with the 60 k Hz IntraLase femtosecond laser. Central, temporal and nasal corneal SNDs were measured by confocal microscopy and compared before surgery, 1 month, and 3 months after surgery. Analysis of variance and t test were used for comparing the differences between different time points and two groups. RESULTS:Preoperatively and 1 month, 3 months postoperatively, the SNDs were (16 728.30 ± 4 300.30), (1 875.42 ± 300.50) and (1 701.55 ± 194.11) µm/mm(2) in the central cornea, (11 379.70 ± 1 833.92), (1 341.20 ± 288.68) and (1 860.87 ± 147.60) µm/mm(2) in the temporal cornea, and (8 506.79 ± 662.83), (7 428.96 ± 712.99) and (8 044.32 ± 1 077.54) µm/mm(2) in the nasal cornea, respectively, in the microkeratome group, and (16 351.59 ± 3 503.88), (1 859.38 ± 452.93) and (2 043.67 ± 377.76) in the central cornea, (12 328.22 ± 2 007.43), (1 483.85 ± 371.28) and (2 126.31 ± 279.87) µm/mm(2) in the temporal cornea, and (8 347.91 ± 789.44), (1 475.53 ± 293.98) and (2 022.10 ± 282.89) µm/mm(2) in the nasal cornea, respectively, in the femtosecond laser group. The SNDs at three positions all decreased significantly at each time point postoperatively compared to the baseline values in both groups (1 and 3 months in the microkeratome group: central t = 18.981 and 18.912, temporal t = 30.121 and 27.921, and nasal t = 6.456 and 2.126; in the femtosecond laser group: central t = 22.667 and 22.379, temporal t = 29.000 and 28.376, and nasal t = 46.329 and 41.751; all P < 0.01, except 3 months at the nasal in the microkeratome group, P = 0.042). The nasal SND increased significantly from month 1 to month 3 (t = -3.921, P < 0.01) in the microkeratome group, and the temporal and nasal SNDs both increased significantly from month 1 to month 3 (t = -9.629 and -6.645, both P < 0.01) in the femtosecond group. There were no significant differences in the central SND between the two groups (F = 0.002, P = 0.96). Significant differences were found in the nasal SND between the groups at 1 month and 3 months (t = 42.281 and 29.608, both P < 0.01), and in the temporal SND at 3 months after surgery (t = -4.595, P < 0.01). CONCLUSIONS:Peripheral corneal nerve recovery occurred at 1 month after LASIK surgery. Patients with a femtosecond laser showed better corneal regeneration than those with a microkeratome.
[The correlations between corneal sensation, tear meniscus volume, and tear film osmolarity after femtosecond laser-assisted LASIK].
Zhang Luyan,Sun Xiyu,Yu Ye,Xiong Yan,Cui Yuxin,Wang Qinmei,Hu Liang
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology
OBJECTIVE:To investigate the correlations between corneal sensation, tear meniscus volume, and tear film osmolarity after femtosecond laser-assisted LASIK (FS-LASIK) surgery. METHODS:In this prospective clinical study, 31 patients undergoing FS-LASIK for myopia were recruited. The upper and lower tear meniscus volumes (UTMV and LTMV) were measured by customized anterior segment optical coherence tomography, tear film osmolarity was measured by a TearLab Osmolarity test device, central corneal sensation was measured by a Cochet-Bonner esthesiometer preoperatively, at 1 week, 1 and 3 months postoperatively. Repeated measures analysis of variance was used to evaluate whether the tear film osmolarity, tear meniscus volume, and corneal sensation were changed after surgery. The correlations between these variables were analyzed by the Pearson correlation analysis. RESULTS:The tear film osmolarity was (310.03 ± 16.48) mOsms/L preoperatively, (323.51 ± 15.92) mOsms/L at 1 week, (319.93 ± 14.27) mOsms/L at 1 month, and (314.97±12.91) mOsms/L at 3 months. The UTMV was (0.42±0.15), (0.25± 0.09), (0.30±0.11), and (0.35±0.09) μL, respectively; the LTMV was (0.60±0.21),(0.37±0.08), (0.44± 0.14), and (0.52±0.17) μL, respectively. The tear film osmolarity was significantly higher at 1 week and 1 month postoperatively compared with the baseline (P=0.001, 0.004), and reduced to the preoperative level at 3 months (P=0.573). The UTMV, LTMV, and corneal sensation values presented significant decreases at all postoperative time points (all P<0.05). The Pearson correlation analysis showed the postoperative UTMV had a weak relationship with corneal sensation at 1 week after surgery (r=0.356,P=0.005). There were significant correlations between the preoperative LTMV and corneal sensation at 1 week, 1 and 3 months (respectively, r=0.422, 0.366, 0.352;P=0.001, 0.004, 0.006). No significant correlations were found between the tear film osmolarity, tear meniscus volume, and corneal sensation after surgery (all P>0.05). CONCLUSION:The tear film osmolarity, tear meniscus volume, and corneal sensation became aggravated due to the FS-LASIK surgery procedures. There were significant correlations between the preoperative tear meniscus volume and recovery of corneal sensation early after surgery. A higher tear meniscus volume before surgery may contribute to a faster corneal sensation recovery.
10.3760/cma.j.issn.0412-4081.2016.01.009
Efficacy Comparison of 16 Interventions for Myopia Control in Children: A Network Meta-analysis.
Huang Jinhai,Wen Daizong,Wang Qinmei,McAlinden Colm,Flitcroft Ian,Chen Haisi,Saw Seang Mei,Chen Hao,Bao Fangjun,Zhao Yune,Hu Liang,Li Xuexi,Gao Rongrong,Lu Weicong,Du Yaoqiang,Jinag Zhengxuan,Yu Ayong,Lian Hengli,Jiang Qiuruo,Yu Ye,Qu Jia
Ophthalmology
PURPOSE:To determine the effectiveness of different interventions to slow down the progression of myopia in children. METHODS:We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov from inception to August 2014. We selected randomized controlled trials (RCTs) involving interventions for controlling the progression of myopia in children with a treatment duration of at least 1 year for analysis. MAIN OUTCOME MEASURES:The primary outcomes were mean annual change in refraction (diopters/year) and mean annual change in axial length (millimeters/year). RESULTS:Thirty RCTs (involving 5422 eyes) were identified. Network meta-analysis showed that in comparison with placebo or single vision spectacle lenses, high-dose atropine (refraction change: 0.68 [0.52-0.84]; axial length change: -0.21 [-0.28 to -0.16]), moderate-dose atropine (refraction change: 0.53 [0.28-0.77]; axial length change: -0.21 [-0.32 to -0.12]), and low-dose atropine (refraction change: 0.53 [0.21-0.85]; axial length change: -0.15 [-0.25 to -0.05]) markedly slowed myopia progression. Pirenzepine (refraction change: 0.29 [0.05-0.52]; axial length change: -0.09 [-0.17 to -0.01]), orthokeratology (axial length change: -0.15 [-0.22 to -0.08]), and peripheral defocus modifying contact lenses (axial length change: -0.11 [-0.20 to -0.03]) showed moderate effects. Progressive addition spectacle lenses (refraction change: 0.14 [0.02-0.26]; axial length change: -0.04 [-0.09 to -0.01]) showed slight effects. CONCLUSIONS:This network analysis indicates that a range of interventions can significantly reduce myopia progression when compared with single vision spectacle lenses or placebo. In terms of refraction, atropine, pirenzepine, and progressive addition spectacle lenses were effective. In terms of axial length, atropine, orthokeratology, peripheral defocus modifying contact lenses, pirenzepine, and progressive addition spectacle lenses were effective. The most effective interventions were pharmacologic, that is, muscarinic antagonists such as atropine and pirenzepine. Certain specially designed contact lenses, including orthokeratology and peripheral defocus modifying contact lenses, had moderate effects, whereas specially designed spectacle lenses showed minimal effect.
10.1016/j.ophtha.2015.11.010
Effects of Long-term Soft Contact Lenses on Tear Menisci and Corneal Nerve Density.
Hu Liang,Chen Jia,Zhang Luyan,Sun Xiyu,Huang Jinhai,Xie Wenjia,Zhang Dong,Wang Qinmei
Eye & contact lens
PURPOSE:We investigated the relationship between tear menisci and corneal subbasal nerve density (SND) in long-term soft contact lens (CL) wearers. METHODS:Three groups were enrolled for this study: asymptomatic non-CL controls (N-CL group), asymptomatic soft CL wearers (A-CL group), and symptomatic soft CL wearers with self-reported moderate to severe dryness (S-CL group). Upper and lower tear menisci height (UTMH, LTMH) and area (UTMA, LTMA) were measured by optical coherence tomography. This was followed by measurements of fluorescein tear breakup time, fluorescein staining, and the Schirmer I test. In vivo confocal microscopy measured the SND in the nasal, central, and temporal regions of the cornea. RESULTS:The UTMH, UTMA, LTMH, and LTMA were significantly lower in the S-CL group compared with the N-CL group (P<0.05). The combined corneal SND of the temporal and nasal regions of the S-CL group was lower than for the N-CL group (P<0.05). The LTMH was correlated with the SND of the temporal (r=0.410), nasal (r=0.423), combined temporal and nasal (r=0.516), and combined temporal, nasal, and central regions (r=0.430, all P<0.01). The LTMA was also correlated with the SND of the temporal (r=0.379), nasal (r=0.292), combined temporal and nasal (r=0.422), and combined temporal, nasal, and central regions (r=0.367, all P<0.05). The temporal and nasal corneal SNDs were more strongly correlated with the LTMH and LTMA than with the UTMH and UTMA. CONCLUSIONS:Soft CL wearers with dry eye symptoms have reduced tear menisci. The alteration of midperipheral corneal SND may contribute to dry eye symptoms.
10.1097/ICL.0000000000000177
The measurement repeatability using different partition methods of intraretinal tomographic thickness maps in healthy human subjects.
Tan Jia,Yang Ye,Jiang Hong,Liu Che,Deng Zhihong,Lam Byron L,Hu Liang,Oakley Jonathan,Wang Jianhua
Clinical ophthalmology (Auckland, N.Z.)
PURPOSE:To determine the repeatability and profiles with different partition methods in intraretinal thickness layers in healthy human subjects, using optical coherence tomography (OCT). METHODS:A custom-built ultrahigh-resolution OCT was used to acquire three-dimensional volume of the macula in 20 healthy subjects. The dataset was acquired twice using the macular cube 512×128 protocol in an area of 6×6 mm centered on the fovea. Commercially available segmentation software (Orion™) was used to segment the dataset into thickness maps of six intraretinal layers. The coefficient of repeatability and intraclass coefficient of correlation (ICC) were analyzed using hemispheric zoning and sectors defined by the Early Treatment Diabetic Retinopathy Study (ETDRS). RESULTS:All datasets were successfully segmented to create six thickness maps of individual intraretinal layers. Coefficients of repeatabilities of these layers in hemispheric zones ranged from 0.9 to 6.6 µm, with an average of 3.6 µm (standard deviation [SD] 1.4), which was not significantly different compared to ETDRS sectors (>0.05). ICCs of these layers in hemispheric zones ranged from 0.68 to 0.99, with an average of 0.91 (SD 0.07). There were no significant differences in ICCs between two zoning methods (>0.05). Significant variations of tomographic intraretinal thicknesses were found between the inner and outer annuli and among the quadrantal sectors within the inner and outer annuli (<0.05). Significant variations of the quadrantal sectors including both inner and outer annuli were evident in intraretinal layers (<0.05) except for the outer plexiform layer. CONCLUSION:The measurement repeatabilities of tomographic thicknesses of intraretinal layers are comparable using both hemispheric and ETDRS partitions in volumetric data combined with the commercially available segmentation software. In keeping with known, normal anatomical variation, significant differences in tomographic thickness in various intraretinal layers were apparent in both hemispheric and ETDRS sectors.
10.2147/OPTH.S117494
Retinal Microvasculature Alteration in High Myopia.
Yang Ye,Wang Jianhua,Jiang Hong,Yang Xiaoling,Feng Limiao,Hu Liang,Wang Liang,Lu Fan,Shen Meixiao
Investigative ophthalmology & visual science
PURPOSE:To investigate the retinal vascular network alterations in highly myopic eyes. METHODS:Thirty-three highly myopic eyes from 21 subjects and 47 mildly myopic or emmetropic eyes from 24 healthy control subjects were enrolled. Optical coherence tomography angiography (OCTA) was used to image the superficial, deep, and whole retinal vascular plexuses at the macular region. Highly myopic eye images were analyzed after adjusting the ocular magnification using Bennett's formula. Fractal analysis (box counting method, Dbox) representing vessel density was performed in different annular and quadrantile zones of both large vessels and microvessels. Correlations between the vascular density, axial length, and spherical equivalent refractive error were analyzed. RESULTS:The average density (Dbox) of the superficial retinal annular zone (0.6-2.5 mm) microvessels was 1.741 ± 0.018 in highly myopic eyes and was shown to be significantly lower than that of the controls (1.773 ± 0.010, P < 0.001). Individual annular zone (bandwidth of 0.16 mm) analysis of highly myopic eyes revealed a significant level of microvessel alteration in all zones compared with the same zones in control eyes (P < 0.001). Furthermore, in the highly myopic group, the microvessel density was significantly correlated with axial length elongation in all three layers (r = -0.38 to -0.48; P < 0.05). CONCLUSIONS:This study reveals retinal microvascular network alterations in highly myopic eyes, which correlates with axial length elongation. Fractal analysis of the microvasculature by OCTA images may help to characterize the underlying pathophysiological mechanisms involved in high myopia.
10.1167/iovs.16-19542
Comparison of Retinal Microvessel Blood Flow Velocities Acquired with Two Different Fields of View.
Zhou Jin,Li Min,Chen Wan,Yang Ye,Hu Liang,Wang Liang,Jiang Hong,Wang Jianhua
Journal of ophthalmology
To compare the different retinal blood flow velocities (BFVs) acquired with different fields of view (FOVs) using the retinal function imager (RFI), twenty eyes of twenty healthy subjects were enrolled in the study. Retinal microvessel BFV in the macula was acquired with both a wide FOV (35 degrees, 7.3 × 7.3 mm) and a commonly used small FOV (20 degrees, 4.3 × 4.3 mm). The 35-degree FOV was trimmed to be equivalent to the 20-degree FOV to compare the BFVs of the similar FOVs using different settings. With the 35-degree FOV, both retinal arteriolar and venular BFVs were significantly greater than the 20-degree FOV ( < 0.001). When the 20-degree FOV was compared to the trimmed equivalent 20-degree FOV acquired using the 35-degree FOV, significant BFV differences were found in both the arterioles ( = 0.029) and venules ( < 0.001). This is the first study to compare retinal blood flow velocities acquired with different FOVs using RFI. The conversion factor from 35 degrees to 20 degrees is 0.95 for arteriolar BFV and 0.92 for venular BFV, which may be used for comparing BFVs acquired with different FOVs.
10.1155/2017/2895982
Postoperative Efficacy, Predictability, Safety, and Visual Quality of Laser Corneal Refractive Surgery: A Network Meta-analysis.
Wen Daizong,McAlinden Colm,Flitcroft Ian,Tu Ruixue,Wang Qinmei,Alió Jorge,Marshall John,Huang Yingying,Song Benhao,Hu Liang,Zhao Yune,Zhu Senmiao,Gao Rongrong,Bao Fangjun,Yu Ayong,Yu Ye,Lian Hengli,Huang Jinhai
American journal of ophthalmology
PURPOSE:To compare the postoperative efficacy, predictability, safety, and visual quality of all major forms of laser corneal refractive surgeries for correcting myopia. DESIGN:Systematic review and network meta-analysis. METHODS:Search of MEDLINE, EMBASE, Cochrane Library, and the US trial registry was conducted up to November 2015. Randomized controlled trials (RCT) reporting in accordance with the eligibility criteria were included in this review. We performed a Bayesian random-effects network meta-analysis. RESULTS:Forty-eight RCTs were identified. For efficacy (uncorrected visual acuity [UCVA]), there were no statistically significant differences between any pair of treatments analyzed. The SUCRA (surface under the cumulative ranking curve) ranking (from best to worst) was femtosecond-based laser in situ keratomileusis (FS-LASIK), LASIK, small-incision lenticule extraction, femtosecond lenticule extraction (FLEx), photorefractive keratectomy (PRK), laser epithelial keratomileusis (LASEK), epipolis (Epi)-LASIK, transepithelial PRK (T-PRK). For predictability (refractive spherical equivalent [SE]), a statistically significant difference was found when FS-LASIK was compared with LASIK (odds ratio [OR] 2.29, 95% credible interval [CrI] 1.20-4.14), PRK (OR 2.16, 95% CrI 1.15-4.03), LASEK (OR 2.09, 95% CrI 1.08-4.55), and Epi-LASIK (OR 2.74, 95% CrI 1.11-6.20). The SUCRA ranking (from best to worst) was FS-LASIK, T-PRK, LASEK, PRK, LASIK, Epi-LASIK. There were no statistically significant differences in the safety (best spectacle-corrected visual acuity) comparisons. For both postoperative higher-order aberrations (HOAs) and contrast sensitivity (CS), there were no statistically significant differences between any pair of treatments analyzed. The SUCRA ranking results show that some corneal surface ablation techniques (PRK and LASEK) rank highest. CONCLUSIONS:This network meta-analysis shows that there were no statistically significant differences in either visual outcomes (efficacy and safety) or visual quality (HOAs and CS). FS-LASIK behaved better in predictability than any other type of surgeries.
10.1016/j.ajo.2017.03.013
Factors Affecting Microvascular Responses in the Bulbar Conjunctiva in Habitual Contact Lens Wearers.
Investigative ophthalmology & visual science
Purpose:To investigate the factors affecting microvascular responses in the bulbar conjunctiva of habitual contact lens (HCL) wearers. Methods:A functional slit-lamp biomicroscope (FSLB) was used to image the temporal bulbar conjunctiva of habitual contact lens (HCL) wearers and non-contact lens (NCL) wearers. The vessel diameters and blood flow velocities (BFVs) were measured. Fractal analysis using Dbox as vessel density and D0 as vessel complexity were used to quantitatively analyze the microvascular network. One eye each of 91 NCL wearers and 75 HCL wearers was imaged. Results:The BFV of NCL wearers was 0.50 ± 0.14 mm/s, which was negatively correlated with age (r = -0.22, P < 0.05). The BFV, vessel diameter, Dbox, and D0 of HCL wearers was significantly higher than NCL wearers (P < 0.05). In these HCL wearers, BFVs were positively correlated with contact lens (CL) hours of wear per day and CL days of wear per week. BFV, Dbox, and D0 were not related to CL years of wear, CL power, CL base curve, and CL diameter (P > 0.05). Conclusions:Vascular responses on the bulbar conjunctiva occurred in HCL wearers and appeared to be unrelated to sex or age, CL years of wear, and lens parameters, indicating that wearing a CL itself may be the predominant factor inducing these responses.
10.1167/iovs.18-24216
Evaluated Conjunctival Blood Flow Velocity in Daily Contact Lens Wearers.
Eye & contact lens
OBJECTIVE:This study examined conjunctival microvasculature development in long-term habitual contact lens (HCL) wearers after a night of sleep. METHODS:Twenty HCL wearers (15 women and 5 men, aged 28.6±6.9 years, mean age±standard deviation) who had worn contact lenses on a daily basis for at least 3 years and 40 noncontact lens (NCL) wearers (23 women and 17 men, aged 36.5±6.6 years, mean age±standard deviation) participated in the study. A functional slitlamp biomicroscopy imaging system was used to image the temporal bulbar conjunctiva. Imaging was performed in the morning while the contact lens wearers were not wearing their lenses after a night of sleep. The conjunctival vessel diameters, blood flow velocities, and flow rates were measured. In addition, fractal analyses were performed to obtain the vessel network density (Dbox) and complexity (D0). RESULTS:The average blood flow velocity in HCL wearers after a night of sleep was 0.59±0.19 mm/s, which was significantly higher than that in NCL wearers (0.48±0.17 mm/s, P<0.05). The microvessel network density and complexity levels (Dbox=1.64±0.05 and D0=1.71±0.05, respectively) in the HCL wearers were significantly higher than those in NCL wearers (Dbox=1.61±0.05 and D0=1.69±0.04, both P<0.05). The blood flow velocity was positively correlated with the duration of contact lens wear (r=0.46, P<0.05) and with the daily number of lens-wearing hours (r=0.49, P<0.05) in HCL wearers. CONCLUSIONS:This study identified microvascular alterations in the conjunctiva in response to daily contact lens wear after a night of sleep in long-term daily contact lens wearers. The unrecovered changes may indicate that para-inflammation occurs on ocular surfaces because of contact lens wear and that overnight sleeping with no lenses may not sufficiently restore the ocular surface to an intact state.
10.1097/ICL.0000000000000389
Inter-visit measurement variability of conjunctival vasculature and circulation in habitual contact lens wearers and non-lens wearers.
Wang Jianhua,Hu Liang,Shi Ce,Jiang Hong
Eye and vision (London, England)
BACKGROUND:The inter-visit variation of measuring bulbar conjunctival microvasculature and microcirculation needs to be considered when the results from multiple visits are interpreted. This study examined the inter-visit variability of measuring conjunctival microvasculature and microcirculation in habitual contact lens (HCL) wearers and non-contact lens (NCL) wearers. METHODS:Twenty-eight subjects were recruited including 13 HCL wearers (10 females and 3 males; mean age ± standard deviation, 25.8 ± 4.6 years) who had worn contact lenses on a daily basis for at least 3 years and 15 NCL wearers (10 females and 5 males, age 25.5 ± 4.0 years) were recruited. The temporal bulbar conjunctiva was imaged using a functional slit-lamp bio-microscope (FSLB) imaging system. FSLB imaging was performed in the morning when the HCL wearers did not wear their lenses. The measurements included conjunctival vessel diameter, vessel density, blood flow velocity and flow volume. In addition, conjunctival microvasculature was analyzed using monofractal (Dbox, representing vessel density) and multifractal (D0 representing vessel complexity) analyses. The repeated measurement was conducted at least one week after the first visit and both eyes of each participant were imaged. The coefficient of variation (CV) was calculated as the standard deviation of the differences between test and re-test then divided by the mean of the measurements. The intra-class correlation coefficient (ICC) was also calculated. RESULTS:No significant differences of all vascular measurements in both the right and left eyes were found between two groups ( > 0.05). Between two measurements on two different visits, the CV was from 2.4% (vessel density D0) to 63.5% (blood flow volume Q) in HCL wearers and from 3.4% (D0) to 40.6% (blood flow volume) in NCL wearers. The ICC was from 0.60 (vessel diameter) to 0.81 (axial blood flow velocity VA) in HCL wearers and from 0.44 (Q) to 0.68 (cross-sectional blood flow velocity VS) in NCL wearers. CONCLUSIONS:The measurement variability of the vessel density of the bulbar conjunctiva appeared to have the smallest inter-visit variation. The measurement variability of the vasculature and circulation in HCL wearers were similar to that in NCL wearers.
10.1186/s40662-019-0135-4
[Application of Deep Learning in Early Diagnosis Assistant System of Keratoconus].
Tan Anzu,Yu Man,Chen Xuan,Hu Liang
Zhongguo yi liao qi xie za zhi = Chinese journal of medical instrumentation
In view of the problem that there is no standard diagnosis for early stage keratoconus disease,at the same time to assist the special examiner and ophthalmologist to make the early diagnosis effectively,the advantages and disadvantages of each testing instrument were analyzed.In order to construct an assistant system for early diagnosis of keratoconus,a deep learning technique was applied in corneal OCT examination.The system used improved VGG-16 to realize the recognition accuracy of about 68% keratoconus keratopathy,and the clinical results showed that the system can help doctors to give diagnosis confidence to a certain extent.At the same time,the physician's re-marking of OCT can help train the system for more accurate judgment.
10.3969/j.issn.1671-7104.2019.02.002
A review of functional slit lamp biomicroscopy.
Shu Xupeng,Wang Jianhua,Hu Liang
Eye and vision (London, England)
Functional slit lamp biomicroscopy (FSLB) is a novel device which consists of a traditional slit-lamp and a digital camera. It can quantitatively assess vessel diameter, blood flow velocity, and blood flow rate and can create noninvasive microvascular perfusion maps (nMPMs). At present, FSLB is mainly used in contact lens (CL) and dry eye disease (DED) studies to advance our understanding of ocular surface microcirculation. FSLB-derived blood flow and vessel density measures are significantly altered in CL wearers and DED patients compared to normal people. These subtle changes in the ocular surface microcirculation may contribute to the monitoring of potential diseases of the body and provide a new way to diagnose dry eye disease. Therefore, this may also indicate that FSLB can be more widely applied in the study of other diseases to reveal the relationship between changes in ocular surface microcirculation and systemic diseases. The purpose of this paper is to summarize the functions of FSLB and the related studies especially in CL and DED.
10.1186/s40662-019-0140-7
Changes in Corneal Dendritic Cell and Sub-basal Nerve in Long-Term Contact Lens Wearers With Dry Eye.
Liu Qiaoli,Xu Zhiqiang,Xu Yangyang,Zhang Junsong,Li Yong,Xia Jiahui,Wang Yuzhou,He Xiaoxing,Qu Jia,Hu Liang
Eye & contact lens
OBJECTIVES:To evaluate the changes of corneal sub-basal nerve (SBN) and dendritic cell (DC) in contact lens (CL) wearers with mild dry eye and their potential relationship. METHODS:Twenty mild dry eye volunteers who had never worn CLs were recruited for long-term CL wearing. Each subject underwent ocular surface evaluations at baseline and at 1, 4, 12, and 24 weeks, including Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (TBUT), and Schirmer I test. In vivo confocal microscopy was used to examine the density, area, number of dendrites, total dendritic length of DC, and SBN densities in central and peripheral corneas. Only right eyes were included. RESULTS:The DCs were activated and peaked at week 4 after wearing CLs. The peripheral DC density increased beginning the first week, whereas the central ones increased by week 4. After 4 weeks, both began to decrease, but still higher than baseline at week 24. The central and peripheral SBN densities decreased. However, the peripheral SBN tended to increase beginning at week 12. In early period, SBN was negatively correlated with DC parameters. After 4 weeks, the correlation changed to be positive. The OSDI increased, whereas the Schirmer I test and TBUT showed no significant change. CONCLUSIONS:After wearing CLs, corneal DC were activated and increased, indicating ocular surface inflammation and decreased after week 4. In the early period, increases in DC may lead to decreases in SBN. Upon decrease of DC, the SBN may regenerate.
10.1097/ICL.0000000000000691