International Ophthalmology

Juvenile foveal retinoschisis is one of the most common causes of bilateral macular degeneration in young boys. School age with accommodative esotropia may develop amblyopia due to late correction of hyperopia. Retinoschisis is hard to diagnose in patient with subtle macula change and hyperopic amblyopia. We report a case of bilateral foveal retinoschisis before and after treatment with topical dorzolamide, which was misdiagnosed as bilateral hyperopic amblyopia. Optical coherence tomography should be considered in diagnostic procedures of children with hyperopic amblyopia.

Objectives To determine the patterns, predictors and overall impact of ocular manifestations of rheumatoid arthritis (RA) on the health-related quality of life and disability index. A total of 50 Nigerian patients with RA were studied. Full ocular evaluation was done to determine the presence of each defined ocular manifestation of RA. All patients completed the Medical Outcome Study 36-Item Short Form Health Survey (SF-36) and the Health Assessment Questionnaire-Disability Index (HAQ-DI) questionnaires. The mean ± SD age of the patients was 47.2 ± 12.5 years. A total of 42 cases of ocular diseases were found in 23 (46%) patients. Keratoconjunctivitis sicca was found in 15 (30%) patients; cataract, 13 (26%); scleritis/episcleritis, 4 (8%); disk edema, 4 (8%); glaucoma, 3 (6%); ulcerative keratitis, 1 (2%); vitreitis, 1 (2%); and macula edema, 1 (2%) patient. There is an association of the presence of ocular manifestations with the physical component summary (PCS) [T = − 3.398, P = 0.001] and the mental component summary (MCS) [T = − 2.616, 0.012] of the SF-36 but not with the HAQ-DI (T = 1.685, 0.099). Following multiple regression analysis, the predictors of the presence of ocular manifestations were age greater than 45 years and positive anti-citrullinated protein antibody. Following linear regression analyses, Steinbrocker’s functional class independently predicted the PCS while both Steinbrocker’s functional class and female sex predicted the MCS. The development of ocular disorders associated with RA is associated with a significant negative impact on the quality of life of the patients.

To investigate the effect of exosomes secreted by human umbilical cord mesenchymal stem cells (HUCMSC-Exo) on aerobic metabolism of cobalt chloride (CoCl2)-induced oxidative damage in the human retinal pigment epithelial cell line (ARPE-19), and to explore the protective mechanism of HUCMSC-Exo on oxidative damage in ARPE-19 cells. HUCMSC-Exo were extracted and identified; CCK-8 assay was used to established the oxidative damage mode of ARPE-19 cells induced by CoCl2; JC-1 flow cytometry was used to detect the effects of exosomes with different concentrations (0, 25, 50, or 100 μg/mL) on the mitochondrial membrane potential (MMP) of oxidatively damaged ARPE-19 cells. The effects of exosomes with different concentrations on the activity of oxidative metabolic enzymes (oxidative respiratory chain complexes I, III, IV, and V) and ATP synthesis in oxidatively damaged ARPE-19 cells were detected by spectrophotometry. Under transmission electron microscope, HUCMSC-Exo were round or oval membrane vesicles with diameters of about 40–100 nm. Western blot results showed that HUCMSC-Exo expressed specific marker proteins CD63 and CD81. CCK-8 dates showed that the cell viability of ARPE-19 cells was significantly decreased with increasing CoCl2 concentration, and the concentration of 400 μmol/L CoCl2 was chosen to be the optimal concentration for oxidative damage. MMP was increased in exosomes intervention group (25, 50 or 100 μg/mL), and the dates were statistically different from 0 μg/mL exosome intervention group (P < 0.05). The activities of mitochondrial complexes I, IV, and V in exosomes intervention groups (100 μg/mL) were higher than those in 0 μg/mL exosome intervention group. In 50 μg/mL and 100 μg/mL exosome intervention group, ATP synthesis was significantly different from the 0 μg/mL exosome intervention group (P < 0.05). HUCMSC-Exo had a certain protective effect on ARPE-19 cells induced by CoCl2 in vitro. The protective mechanism of HUCMSC-Exo on oxidative damage ARPE-19 cells might be through saving its aerobic metabolic function, restoring cell ATP synthesis, and improving the ability of cells to repair damage and deal with the hypoxic environment.

The aim of this study was to compare wavefront aberrations before and after Nd:YAG capsulotomy in multifocal intraocular lens (MfIOL) and monofocal (MoIOL) pseudophakic eyes with posterior capsule opacification (PCO). Wavefront aberrations were measured using a ARK-10000 topographer before and after Nd:YAG capsulotomy in eyes that underwent MfIOL or MoIOL implantation and developed PCO. Total and higher-order aberrations (HOAs) values were evaluated as root mean square (RMS). The study included 64 eyes with MfIOLs (64 patients) and 72 with MoIOLs (72 patients) that developed PCO. Total RMS values before and 1 month after Nd:YAG capsulotomy were 0.863 ± 0.27 and 0.504 ± 0.24 in the MFIOL group and 0.862 ± 0.31 and 0.466 ± 0.26 in the MoIOL group, respectively. Total RMS values did not differ significantly between the groups before (p = 0.914) or 1 month after Nd:YAG laser capsulotomy (p = 0.357), but decreased significantly after Nd:YAG capsulotomy compared to baseline in both the MfIOL (p = 0.027) and MoIOL (p = 0.012) groups. HOA values before and 1 month after Nd:YAG capsulotomy were 0.546 ± 0.23 and 0.364 ± 0.19 in the MfIOL group and 0.500 ± 0.21 and 0.346 ± 0.18 in the MoIOL group, respectively. HOA values did not differ significantly before (p = 0.828) or after Nd:YAG capsulotomy (p = 0.111), while both groups showed significant reduction in HOAs after Nd:YAG capsulotomy (MfIOL: p = 0.021, MoIOL: p = 0.027). Nd:YAG capsulotomy reduces total and HOAs to the same extent in eyes with both MfIOLs and MoIOLs, with no significant impact of the IOL design.

To achieve an accurate diagnosis of idiopathic epiretinal membrane (iERM) through analyzing retinal blood vessel oxygen saturation (SO2) and vascular morphological features in fundus images. Dual-modal fundus camera was used to obtain color fundus image, 570-nm, and 610-nm images. As iERM affects the macular area, a macular-centered semicircle area as region of interest (MROI) was selected and analyzed SO2 and vascular morphologies in it. Eventually, random forest (RF) and support vector machine (SVM) were as classifiers to diagnose iERM patients. The arterial and venous SO2 levels of the iERM group were significantly higher than that of the control group. There were significant differences in the vessel density and fractal dimension on the artery for vascular morphology, while the tortuosity had a significant difference in the vein. By feeding the SO2 and the vascular morphological features into classifiers, an accuracy of over 82% was obtained, which is significantly better than the two separate inputs for classification. Significant differences in SO2 and vascular morphologies between control and iERM groups confirmed that the occurrence of iERM may affect blood supply and vascular structures. Benefiting from the dual-modal fundus camera and machine learning models, accurate judgments can be made on fundus images. Extensive experiments proved the importance of blood vessel SO2 and vascular morphologies for diagnosis, which is of great significance for clinical screening.