Long-Term Natural Course of Pathologic Myopia in Chinese Patients

Purpose. To investigate the natural progression in Chinese patients with pathological myopia (PM) and its associated factors. Methods. The medical records of 28 patients with PM (worse than −6 diopter), including 31 eyes of 21 children and 12 eyes of 7 adults, were studied. All of the patients underwent a complete ophthalmologic examination at least twice over 3-year period, including the measurement of refractive error (shown as spherical equivalent, SE), axial length (AL), intraocular pressure, visual acuity (uncorrected visual acuity, UCVA, and best-corrected visual acuity, BCVA), and dilated fundus examination. Results. The median AL of adults increased significantly from 29.8 mm to 31.43 mm over 5.4 years follow-up (P=0.0037), accompanied with the median SE progressing significantly from −16.4 D to −18.94 D (P=0.0005). Similarly, the median AL of children increased significantly from 26.13 mm to 27.81 mm over 3.9 years (P=0.0001). However, the improvements of UCVA and BCVA in children were significant (P=0.0304, 0.0001), and they had a negative correlation with age (P=0.0010, 0.0005). Also, UCVA and BCVA in children with bilateral PM were significantly better than those with unilateral PM (P=0.0385, 0.0210). Conclusions. Fundus degenerations in children with pathological myopia may lead its way since the age of 10 years. Besides, children with bilateral pathological myopia can have parallel development in visual acuity

The sonic hedgehog signaling pathway induces myopic development by activating matrix metalloproteinase (MMP)-2 in Guinea pigs.

PURPOSE: To investigate whether the Sonic hedgehog (Shh) signaling induces myopic development by increasing the expression of matrix metalloproteinase (MMP)-2 in guinea pigs. METHODS: A translucent diffuser was glued onto the right eye to induce form-deprivation myopia (FDM) in 10 guinea pigs. Four guinea pigs were served as a control group. The other 100 guinea pigs were subdivided into 5 groups (20 per group) and received a 10 µl intravitreal injection every 2 days for 4 times. Two groups were injected with 20 or 50 µg/ml Shh amino-terminal peptide (Shh-N) into the right eye and 0.1% bovine serum albumin into the other. FDM was induced in the right eyes of the three cyclopamine-treated groups and both eyes were injected with 50, 100, or 200 µg/ml cyclopamine. Retinoscopic refraction and eye dimensions were assessed on Day 14 of treatment. MMP-2 protein expression was determined in both scleras by western blotting. RESULTS: Both concentrations of Shh-N stimulated myopic development and axial growth as compared with control eyes. Myopia and axial elongation were significantly greater in the 50 µg/ml than in the 20 µg/ml Shh-N group (P<0.001 and P = 0.0019, respectively). All three doses of cyclopamine significantly attenuated myopic development compared with the FDM group (P<0.0001). Cyclopamine at 100 or 200 µg/ml significantly reduced axial elongation compared with the FDM group (P = 0.044 and P = 0.001, respectively). FDM-induced myopia and axial elongation were significantly greater in the 50 µg/ml than in the 200 µg/ml cyclopamine group (P<0.0001 and P = 0.008, respectively). MMP-2 expression was significantly greater in Shh-N-treated eyes than in the control eyes, and was lower in the cyclopamine plus FDM groups than in the FDM group. CONCLUSIONS: The Shh signaling pathway induces myopic development by activating MMP-2 in guinea pigs

Dry Eye Disease following Refractive Surgery: A 12-Month Follow-Up of SMILE versus FS-LASIK in High Myopia

Purpose. To compare dry eye disease following SMILE versus FS-LASIK. Design. Prospective, nonrandomised, observational study. Patients. 90 patients undergoing refractive surgery for myopia were included. 47 eyes underwent SMILE and 43 eyes underwent FS-LASIK. Methods. Evaluation of dry eye disease was conducted preoperatively and at 1, 3, 6, and 12 months postoperatively, using the Salisbury Eye Evaluation Questionnaire (SEEQ) and TBUT. Results. TBUT reduced following SMILE at 1 and 3 months (p<0.001) and at 1, 3, and 6 months following FS-LASIK (p<0.001). TBUT was greater following SMILE than FS-LASIK at 3, 6, and 12 months (p<0.001, p<0.001, and p=0.009, resp.). SEEQ scores increased (greater symptoms) following SMILE at 1 month (p<0.001) and 3 months (p=0.003) and at 1, 3, and 6 months following FS-LASIK (p<0.001). SMILE produced lower SEEQ scores (fewer symptoms) than FS-LASIK at 1, 3, and 6 months (p<0.001). Conclusion. SMILE produces less dry eye disease than FS-LASIK at 6 months postoperatively but demonstrates similar degrees of dry eye disease at 12 months

Western blotting analysis of MMP-2 protein expression in the sclera of guinea pigs following FDM and intravitreal cyclopamine injection.

<p>FDM: form-deprivation myopia; Cyclo: cyclopamine; R: right eye; L: left eye; MMP-2: matrix metalloproteinase-2.</p

Experimental groups and reasons for excluding guinea pigs with FDM and treated with cyclopamine.

<p>FDM: form-deprivation myopia; Cyclo: cyclopamine.</p

Experimental groups and reasons for excluding guinea pigs treated with Shh-N.

<p>Shh-N: Shh amino-terminal peptide.</p

Pathologic examination of eye sections stained with hematoxylin and eosin.

<p>The retina of eyes treated with Shh-N (B) were morphologically indistinguishable from control eyes treated with solvent alone (A). Shh-N: Shh amino-terminal peptide.</p

Effects of intravitreal cyclopamine administration and FDM on refraction and eye dimensions.

<p>Values represent the difference between the right and left eyes and are presented as the mean ± SD. FDM: form-deprivation myopia; ACD: anterior chamber depth; Cyclo: cyclopamine.</p