最新刊期
      2023 年 第 4 期

        Review

      • Qiyu Qin,Chengshou Zhang,Naiji Yu,Fan Jia,Xin Liu,Qi Zhang,Min Chen,Kaijun Wang
        2023, 3(4): 171-179. DOI: 10.1016/j.aopr.2023.09.001
        摘要：

        Background

        Glaucoma is the leading cause of irreversible blindness worldwide. The reduction of intraocular pressure has proved to be the only factor which can be modified in the treatment, and surgical management is one of the important methods for the treatment of glaucoma patients.

        Main text

        In order to increase aqueous humor outflow and further reduce intraocular pressure, various drainage implants have been designed and applied in clinical practice. From initial Molteno, Baerveldt and Ahmed glaucoma implants to the Ahmed ClearPath device, Paul glaucoma implant, EX-PRESS and the eyeWatch implant, to iStent, Hydrus, XEN, PreserFlo, Cypass, SOLX Gold Shunt, etc., glaucoma surgical implants are currently undergoing a massive transformation on their structures and performances. Multitudinous materials have been used to produce these implants, from original silicone and porous polyethylene, to gelatin, stainless steel, SIBS, titanium, nitinol and even 24-carat gold. Moreover, the material geometry, size, rigidity, biocompatibility and mechanism (valved versus nonvalved) among these implants are markedly different. In this review, we discussed the development and material characteristics of both conventional glaucoma drainage devices and more recent implants, such as the eyeWatch and the new minimally invasive glaucoma surgery (MIGS) devices.

        Conclusions

        Although different in design and materials, these delicate glaucoma surgical implants have widely expanded the glaucoma surgical methods, and improved the success rate and safety of glaucoma surgery significantly. However, all of these glaucoma surgical implants have various limitations and should be used for different glaucoma patients at different conditions.  
        关键词：Glaucoma drainage devices;Minimally invasive glaucoma surgery;Material characteristics   
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        发布时间：2023-11-15
      • Zaoxia Guo,Xiaopan Ma,Rui Xue Zhang,Hong Yan
        2023, 3(4): 180-186. DOI: 10.1016/j.aopr.2023.10.001
        摘要：

        Background

        Cataract is a blinding disease worldwide. It is an age-related disease that mainly occurs in people over 65 years old. Cataract is also prevalent in patients with diabetes mellites (DM). The pathological mechanisms underlying diabetic cataract (DC) are more complex than that of age-related cataract. Studies have identified that polyol pathway, advanced glycation end products (AGEs) and oxidative stress are the primary pathogenesis of DC. In recent years, molecular-level regulations and pathological processes of lens epithelial cells (LECs) have been confirmed to play roles in the initiation and progression of DC. A comprehensive understanding and elucidation of how chronic hyperglycemia drives molecular-level regulations and cytopathological processes in the lens will shed lights on the prevention, delay and treatment of DC.

        Main text

        Excessive glucose in the lens enhances polyol pathway and AGEs formation. Polyol pathway causes imbalance in the ratio of NADPH/NADP+ and NADH/NAD+. Decrease in NADPH/NADP+ ratio compromises antioxidant enzymes, while increase in NADH/NAD+ ratio promotes reactive oxygen species (ROS) overproduction in mitochondria, resulting in oxidative stress. Oxidative stress in the lens causes oxidation of DNA, proteins and lipids, leading to abnormalities in their structure and functions. Glycation of proteins by AGEs decreases solubility of proteins. High glucose triggered epigenetic regulations directly or indirectly affect expressions of genes and proteins in LECs. Changes in autophagic activity, increases in fibrosis and apoptosis of LECs destroy the morphological structure and physiological functions of the lens epithelium, disrupting lens homeostasis.

        Conclusions

        In both diabetic animal models and diabetics, oxidative stress plays crucial roles in the formation of cataract. Epigenetic regulations, include lncRNA, circRNA, microRNA, methylation of RNA and DNA, histone acetylation and pathological processes, include autophagy, fibrosis and apoptosis of LECs also involved in DC.  
        关键词：Oxidative stress;Epigenetic regulation;Autophagy;Fibrosis;Apoptosis;Diabetic cataract   
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        发布时间：2023-11-15

        Full Length Article

      • Zhao Geng,Ling Gao,Chongyi Li,He Xiao,Liqi Fan,Pei Liu,Juan Yu,Rongdi Yuan,Jian Ye
        2023, 3(4): 153-158. DOI: 10.1016/j.aopr.2023.07.002
        摘要：

        Purpose

        To explore the effect of the variation of pupil diameter (PD) and intraocular pressure (IOP) induced by femtosecond laser treatment on the subsequent phacoemulsfication and intraocular lens implantation. And whether the application of 0.1% pranoprofen could significantly reduce the miosis and increased IOP caused by femtosecond laser treatment in femtosecond laser-assisted cataract surgery (FLACS).

        Methods

        In this study, patients were pretreated with (trial group) or without (control group) topical 0.1% pranoprofen. The PD and IOP were measured at different time points within 30 ​min after the completion of the femtosecond laser treatment.

        Results

        The comparisons of the two groups showed the PD of patients pretreated with 0.1% pranoprofen was significantly larger than that of the control only at 15 ​min after FLACS (P ​= ​0.046), and there was no significant difference in IOP at any time point (P ​> ​0.05). Neither the ratio of significant miosis (PD ​≤ ​5 ​mm) nor intraocular hypertension (IOP ≥30 ​mmHg) was significantly different between the control group (1.72%, 6.67%) and the trial group (1%, 4.17%) (P ​> ​0.05).

        Conclusions

        The PD and IOP of patients undergoing FLACS showed fluctuations within a small range. The rates of significant miosis and intraocular hypertension are very low, it is safe for surgeons to complete the follow-up procedures within 30 ​min after femtosecond laser treatment. Pretreatment with 0.1% pranoprofen exerted a slight, albeit significant prophylactic effect preventing pupil miosis. However, it provided only a limited benefit in patients undergoing FLACS without other complications.  
        关键词：Pupil diameter;Intraocular pressure;Femtosecond;Cataract   
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        发布时间：2023-11-15
      • Hao Wang,Qiang Ye,Weihe Xu,Jing Wang,Jianhan Liu,Xintong Xu,Wenfang Zhang
        2023, 3(4): 159-170. DOI: 10.1016/j.aopr.2023.07.003
        摘要：

        Background

        Randomized controlled trials (RCTs) are often considered the gold standard and the cornerstone for clinical practice. However, bibliometric studies on worldwide RCTs of ophthalmology published in the 21st century have not been reported in detail yet. This study aims to perform a bibliometric study and visualization analysis of worldwide ophthalmologic RCTs in the 21st century.

        Methods

        Global ophthalmologic RCTs from 2000 to 2022 were searched in the Web of Science Core Collection. The number of publications, country/region, institution, author, journal, and research hotspots of RCTs were analyzed using HistCite, VOSviewer, CiteSpace, and Excel software.

        Results

        2366 institutions and 90 journals from 83 countries/regions participated in the publication of 1769 global ophthalmologic RCTs, with the United States leading in the number of volumes and research field, and the Moorfields Eye Hospital contributing to the most publications. Ophthalmology received the greatest number of publications and co-citations. Jeffrey S. Heier owned the most publications and Jost B. Jonas owned the most co-citations. The knowledge foundations of global ophthalmologic RCTs were mainly retinopathy, glaucoma, dry eye disease (DED), and cataracts, and anti-vascular endothelial growth factor (VEGF) therapy (ranibizumab), topical ocular hypotensive medication, laser trabeculoplasty. Anti-VEGF therapy for age-related macular degeneration (AMD), DME (diabetic macular edema), and DED, the use of new diagnostic tools, and myopia were the hottest research highlights. Anti-VEGF therapy, prompt laser, triamcinolone, and verteporfin photodynamic therapy for AMD, DME, and CNV (choroidal neovascularization), DED, myopia, and open-angle glaucoma were the research hotspots with the longest duration. The future research hotspots might be DED and the prevention and control of myopia.

        Conclusions

        Overall, the number of global ophthalmologic RCTs in the 21st century was keeping growing, there was an imbalance between the regions and institutions, and more efforts are required to raise the quantity, quality, and global impact of high-quality clinical evidence in developing countries/regions.  
        关键词：Ophthalmology;Randomized controlled trials (RCTs);The 21st century;Worldwide;Bibliometric;Research trends   
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        发布时间：2023-11-15
      • Trevor Chen,Richard Chen,Alvin You,Valentina L. Kouznetsova,Igor F. Tsigelny
        2023, 3(4): 187-191. DOI: 10.1016/j.aopr.2023.09.002
        摘要：

        Purpose

        Patients with diabetes mellitus have an elevated chance of developing cataracts, a degenerative vision-impairing condition often needing surgery. The process of the reduction of glucose to sorbitol in the lens of the human eye that causes cataracts is managed by the Aldose Reductase Enzyme (AR), and it is been found that AR inhibitors may mitigate the onset of diabetic cataracts. There exists a large pool of natural and synthetic AR inhibitors that can prevent diabetic complications, and the development of a machine-learning (ML) prediction model may bring new AR inhibitors with better characteristics into clinical use.

        Methods

        Using known AR inhibitors and their chemical-physical descriptors we created the ML model for prediction of new AR inhibitors. The predicted inhibitors were tested by computational docking to the binding site of AR.

        Results

        Using cross-validation in order to find the most accurate ML model, we ended with final cross-validation accuracy of 90%. Computational docking testing of the predicted inhibitors gave a high level of correlation between the ML prediction score and binding free energy.

        Conclusions

        Currently known AR inhibitors are not used yet for patients for several reasons. We think that new predicted AR inhibitors have the potential to possess more favorable characteristics to be successfully implemented after clinical testing. Exploring new inhibitors can improve patient well-being and lower surgical complications all while decreasing long-term medical expenses.  
        关键词：Diabetic cataracts;Aldose reductase inhibitor;Machine learning;Deep learning   
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        发布时间：2023-11-15
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