Recent advances in ocular graft-versus-host disease

Ocular graft-versus-host-disease (GVHD) remains a significant clinical complication after allogeneic hematopoietic stem cell transplantation. Impaired visual function, pain, and other symptoms severely affect affected individuals’ quality of life. However, the diagnosis of and therapy for ocular GVHD involve a multidisciplinary approach and remain challenging for both hematologists and ophthalmologists, as there are no unified international criteria. Through an exploration of the complex pathogenesis of ocular GVHD, this review comprehensively summarizes the pathogenic mechanism, related tear biomarkers, and clinical characteristics of this disease. Novel therapies based on the mechanisms are also discussed to provide insights into the ocular GVHD treatment

The effect of health insurance reform on the number of cataract surgeries in Chongqing, China

<p>Abstract</p> <p>Background</p> <p>Cataracts are the leading cause of blindness in China, and poverty is a major barrier to having cataract surgery. In 2003, the Chinese government began a series of new national health insurance reforms, including the New Cooperative Medical Scheme (NCMS) and the Urban Resident Basic Health Insurance scheme (URBMI). These two programs, combined with the previously existing Urban Employee Basic Health Insurance (UEBMI) program, aimed to make it easier for individuals to receive medical treatment. This study reports cataract surgery numbers in rural and urban populations and the proportion of these who had health insurance in Chongqing, China from 2003 to 2008.</p> <p>Methods</p> <p>The medical records of a consecutive case series, including 14,700 eyes of 13,262 patients who underwent age-related cataract surgery in eight hospitals in Chongqing from January 1, 2003, to December 31, 2008, were analysed retrospectively via multi-stage cluster sampling.</p> <p>Results</p> <p>In the past six years, the total number of cataract surgeries had increased each year as had the number of patients with insurance. Both the number of surgeries and the number of insured patients were much higher in the urban group than in the rural group. The rate of increase in the rural group however was much higher than in the urban group, especially in 2007 and 2008. The odds ratios of having health insurance for urban vs. rural individuals were relatively stable from 2003 to 2006, but it decreased in 2007 and was significantly lower in 2008.</p> <p>Conclusions</p> <p>Health insurance appears to be an important factor associated with increased cataract surgery in Chongqing, China. With the implementation of health insurance, the number of Chongqing's cataract surgeries was increased year by year.</p

Central retinal artery occlusion without cherry-red spots

Abstract Background Cherry-red spots are a very important sign for the clinical diagnosis of central retinal artery occlusion (CRAO). We retrospectively summarized the clinical manifestations of CRAO and analysed the causes and characteristics of CRAO without cherry-red spots. In this study, we explored a diagnostic method for CRAO without cherry red spots. Methods Seventy patients (70 eyes) with CRAO were examined retrospectively. Corrected distance visual acuity, fundus photos, FA and OCT images were collected at the first outpatient visit. The causes of CRAO without cherry-red spots were analysed through fundus photos. The incidence of increased hyperreflectivity of the inner retina, central macular thickness (CMT) and arteriovenous transit time in patients with and without cherry-red spots were compared. Results Fundus examination showed posterior retinal whitening in 57 cases (81.43%) and cherry-red spots in 39 cases (55.71%). Thirty-one patients presented at the first outpatient visit without cherry-red spots. The reasons for the absence of cherry-red spots included leopard fundus (32.26%), retinal vein occlusion (25.81%), no obvious inner retinal coagulative necrosis (19.35%), ciliary retinal artery sparing (12.90%), high macular oedema (9.68%) and cherry-red spot enlargement (3.23%). OCT revealed increased hyperreflectivity of the inner retina in 67 CRAO patients (95.71%). All 3 patients without increased hyperreflectivity of the inner retina did not present with cherry-red spots at the first visit. The median CMT in patients without cherry-red spots was 166.00 μm, while the median MCT in patients with cherry-red spots was 180.00 μm; there was no significant difference between these two groups (P = 0.467). FA showed delayed arteriovenous transit time > 23 s in 20 patients (28.57%), > 15 s in 43 patients (61.43%) and no delay in 27 patients (30.77%). The median arteriovenous transit time in patients without cherry-red spots was 19.00 s, while it was 18.00 s in patients with cherry-red spots; there was no significant difference between these two groups (P = 0.727). Conclusions There are multiple factors that could cause the absence of cherry-red spots in CRAO. The use of OCT to observe increased hyperreflectivity of the inner retina is the most effective imaging method for the early diagnosis of CRAO without cherry-red spots

The Relationship between Anterior Chamber Angle and Intraocular Pressure Early after V4c Implantable Collamer Lens Implantation

Purpose. To confirm the relationship between anterior chamber angle (ACA) and intraocular pressure (IOP) early after V4c implantable collamer lens (ICL) implantation. Methods. Patients were assigned to two groups: (1) right eyes (control group) and (2) left eyes (experimental group), with miosis conducted immediately after ICL implantation in the left eyes. IOP, angle opening distance (AOD), trabecular-iris angle (TIA), and pupil diameter (PD) were compared between two groups at postoperative hours 1, 2, and 24. The relationship between ACA, PD, and IOP was analyzed by multiple linear regression. Result. Thirty-six eyes of 18 patients were enrolled. The prevalence of ocular hypertension (OHT, defined as IOP ≥ 21 mmHg) was 61.11% and 16.67% in the right and left eyes, respectively, (χ2 = 7.481, p=0.006). At postoperative hours 1 and 2, IOP and PD were significantly higher p<0.001 in the right eyes, and TIA and AOD were significantly lower p<0.05 in the right eyes than in the left eyes. There was no significant difference at 24 h postoperative in these parameters. After the right eye ICL implantation, the changes of AOD 500 and PD were both linearly correlated with postoperative IOP change (β = −23.707 and 1.731, respectively; p = 0.013 and 0.002, respectively). Conclusion. The ACA was significantly narrowed immediately after V4c ICL implantation. There was a negative linear correlation between ACA and early IOP and a positive linear correlation between PD and early IOP. We recommend the use of intracameral miotics immediately after V4c ICL implantation to reduce the incidence of IOP spikes

Fluctuations in Intraocular Pressure Increase the Trabecular Meshwork Extracellular Matrix

Background/Aims: The trabecular meshwork (TM) tissue is constantly exposed to dynamic stress caused by intraocular pressure (IOP). The effects of such biomechanical stress on the TM have not been analyzed. This study developed an animal model of fluctuating IOP and evaluated the effects of these fluctuations on TM tissue. Methods: To create fluctuation in the IOP, one eye of adult SD rats was exposed to cyclic stress with IOP fluctuation ranging from 5 mmHg to 45 mmHg at a 1/60 Hz frequency for 30 minutes every day for several weeks. The other eye was not treated and served as the control. Hematoxylin-eosin staining was used to evaluate changes in the ganglion cells and the morphology, thickness and density of the TM; immunohistochemistry was used to detect α-smooth muscle actin (α-SMA), laminin (LA) and fibronectin (FN) expression in the TM. Results: After several weeks of daily IOP fluctuation, the TM thickness remained unchanged, whereas the density dramatically increased. α-SMA, LA and FN were expressed in rat TM tissue, and the percentages of areas with positive expression significantly increased. The IOP was similar in the treated and control eyes and only tended to increase on day 22 of the experiment. Throughout the 28-day experiment, no ganglion cells were lost. Conclusions: Large fluctuations in IOP promoted the synthesis of α-SMA, LA and FN in the TM and increased the density of the TM, suggesting that fluctuations in IOP can induce pathological changes in the TM

An integrated tunable isolator based on NiZn film fabricated by spin-spray plating

An innovative type of tunable isolator with a planar comb-like microstrip transmission line, which generate circular polarization magnetic field, has been realized with polycrystalline NiZn ferrite thick films fabricated by spin-spray plating (SSP) process with thickness of 10μm. The phase compositions, microstructure, magnetic hysteresis loop, and ferromagnetic resonance (FMR) linewidth of NiZn ferrite thick films have been characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), vibrating sample magnetometer (VSM) and electron spin resonance (ESR) spectrometer, respectively. The NiZn ferrite thick films possess 4800Gauss saturation magnetization and 190Oe FMR linewidth measured at X-band. With an in-plane dc magnetic bias perpendicular to the comb-like microstrip transmission line, the transmission direction of left-hand circular polarization (LHCP) and right-hand circular polarization (RHCP) were proved to be opposite. The non-reciprocal ferromagnetic resonance absorption leads to 11.6dB isolation and 5.78dB insertion loss at 17.57GHz with magnetic bias field of 3.5kOe. Furthermore, with external in-plane magnetic fields range from 0.5kOe to 3.5kOe, the central frequency was tuned from 5.63GHz to 17.57GHz. The state-of-the-art tunable isolator with a planar comb-like microstrip transmission line exhibit a great potential to be applied in different microwave components and radar system

The necessity of pretreatment with 0.1% pranoprofen for femtosecond-assisted cataract surgery: A single-center, randomized controlled trial

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