• Volume 10,Issue 8,2017 Table of Contents
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    • >Basic Research
    • Blockade of angiopoietin-2/Tie2 signaling pathway specifically promotes inflammation-induced angiogenesis in mouse cornea

      2017, 10(8):1187-1194. DOI: 10.18240/ijo.2017.08.01 CSTR:

      Abstract (1683) HTML (232) PDF 7.86 M (697) Comment (0) Favorites

      Abstract:AIM: To investigate angiopoietin-2 (Ang-2)/Tie2 signaling pathway involving in inflammatory angiogenesis. METHODS: Three interrupted 11-0 nylon sutures were placed into the corneal stroma of BALB/c mice (6wk old) to induce inflammatory neovascularization. Expression of Ang-2 and Tie2 protein on neovascularization were examined by immunofluorescence. The dynamic expression of Ang-2 mRNA on neovascularization was examined by quantitative real-time reverse transcriptase-polymerase chain reaction (RT-PCR). Finally, the mouse model of suture- induced corneal neovascularization was used to assess the role of Ang-2/Tie2 signaling pathway in inflammatory angiogenesis by systemic application of L1-10, an Ang-2 specific inhibitor. Mouse corneal hemangiogenesis were evaluated by whole mount immunofluorescence. RESULTS: Both Ang-2 and Tie2 were expressed on newly generated blood vessels in inflammatory cornea. Ang-2 expression was gradually upregulated around 2wk following injury, which was concurrent with an increased number of blood vessels. Blockade of Ang-2/Tie2 signaling pathway obviously promoted angiogenesis in inflammatory cornea. CONCLUSION: Ang-2/Tie2 signaling pathway seems to play an important role during angiogenesis in inflammatory cornea. This may open new therapeutic applications in pathological processes such as corneal graft survival, wound healing and carcinogenesis.

    • MiR-200c suppresses the migration of retinoblastoma cells by reversing epithelial mesenchymal transition

      2017, 10(8):1195-1202. DOI: 10.18240/ijo.2017.08.02 CSTR:

      Abstract (1742) HTML (219) PDF 1.38 M (748) Comment (0) Favorites

      Abstract:AIM: To analyze the relationship between clinical features and epithelial mesenchymal transition (EMT) in retinoblastoma (RB), further to investigate whether miR-200c regulates the EMT and migration of RB cells. METHODS: Expression of EMT-related markers and tumor-related factors were detected by immuno-histochemistry analysis in RB tissue from 29 cases. Correlations between their expression and clinical characteristics were analyzed. The regulation effects of miR-200c on EMT-related markers, tumor-related factors were observed in mRNA level and protein level by real-time polymerase chain reaction (PCR) and Western blot, respectively, in Y79 and Weri-rb1 cells. Its effects on migration force of these RB cell lines were also detected with Transwell test. RESULTS: Lower expression of E-cadherin was present in the cases with malignant prognosis. MiR-200c promoted the expression of E-cadherin and decreased the expression of Vimentin and N-cadherin in Y79 and Weri-rb1 cells. Migration force of RB cells could be inhibited by miR-200c. CONCLUSION: EMT might be associated with bad prognosis in RB. MiR-200c suppresses the migration of retinoblastomatous cells by reverse EMT.

    • Aralia elata inhibits neurodegeneration by downregulating O-GlcNAcylation of NF-κB in diabetic mice

      2017, 10(8):1203-1211. DOI: 10.18240/ijo.2017.08.03 CSTR:

      Abstract (1861) HTML (217) PDF 2.72 M (647) Comment (0) Favorites

      Abstract:AIM: To investigate the role of O-GlcNAcylation of nuclear factor-kappa B (NF-κB) in retinal ganglion cell (RGC) death and analysedthe effect of Aralia elata (AE) on neurodegeneration in diabetic mice. METHODS: C57BL/6mice with streptozotocin-induced diabetes were fed daily with AE extract or control (CTL) diet at the onset of diabetes mellitus (DM). Two months after injection of streptozotocin or saline, the degree of cell death and the expression of O-GlcNAc transferase (OGT), N-acetyl-b-D-glucosaminidase (OGA), O-GlcNAcylated proteins, and O-GlcNAcylation of NF-κB were examined. RESULTS: AE did not affect the metabolic status of diabetic mice. The decrease in the inner retinal thickness (P<0.001 vs CTL, P<0.01 vs DM) and increases in RGCs with terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling (P<0.001 vs CTL, P<0.0001 vs DM), glial activation, and active caspase-3 (P<0.0001 vs CTL, P<0.0001 vs DM) were blocked in diabetic retinas of AE extract-fed mice. Expression levels of protein O-GlcNAcylation and OGT were increased in diabetic retinas (P<0.0001 vs CTL), and the level of O-GlcNAcylation of the NF-κB p65 subunit was higher in diabetic retinas than in controls (P<0.0001 vs CTL). AE extract downregulated O-GlcNAcylation of NF-κB and prevented neurodegeneration induced by hyperglycemia (P<0.0001 vs DM). CONCLUSION: O-GlcNAcylation of NF-κB is concerned in neuronal degeneration and that AE prevents diabetes-induced RGC apoptosis via downregulation of NF-κB O-GlcNAcylation. Hence, O-GlcNAcylation may be a new object for the treatment of DR, and AE may have therapeutic possibility to prevent diabetes-induced neurodegeneration.

    • Inhibitory effect of tenomodulin versus ranibizumab on in vitro angiogenesis

      2017, 10(8):1212-1216. DOI: 10.18240/ijo.2017.08.04 CSTR:

      Abstract (1475) HTML (229) PDF 1.01 M (716) Comment (0) Favorites

      Abstract:AIM: To evaluate anti-angiogenic effect of tenomodulin (TNMD) and ranibizumab on cell proliferation and capillary-like morphogenesis of vascular endothelial cells under the stimulation of vascular endothelial growth factor (VEGF) in vitro. METHODS: The effects of TNMD and ranibizumab on VEGF-induced proliferation of human umbilical vein endothelial cells (HUVECs) were evaluated by MTT assay, and the effects of TNMD and ranibizumab on capillary-like structures formed by HUVECs under the stimulation of VEGF were examined in culture. Capillary-like morphogenesis of HUVECs was quantitatively evaluated, and total lengths of tube-like structures per field were measured in a masked way. RESULTS: HUVECs with both ranibizumab and TNMD protein showed MTT reduction in VEGF-stimulated cell proliferation as expected, while MTT absorbance in the HUVECs with TNMD was significantly declined than that with ranibizumab (P<0.01). The capillary-like structures formed by HUVECs were markedly impaired by the presence of both TNMD and ranibizumab in the culture medium. The total length of the capillary-like structures per field was significantly shorter in the medium with TNMD than that of ranibizumab (P<0.01). The inhibitory effect of TNMD on tube formation in vitro angiogenesis was significantly stronger than that of ranibizumab. CONCLUSION: TNMD may have stronger inhibitory effect than ranibizumab on in vitro angiogenesis.

    • Possible role of sialylation of retinal protein glycans in the regulation of electroretinogram response in mice

      2017, 10(8):1217-1222. DOI: 10.18240/ijo.2017.08.05 CSTR:

      Abstract (1897) HTML (232) PDF 880.03 K (628) Comment (0) Favorites

      Abstract:AIM: To evaluate if the nature, degree and extent of Siaα2-3-/Siaα2-6-sialylation of retinal protein glycans plays a possible role in the development and regulation of electroretinogram response (ERG) in mice. METHODS: Proteins extracted, from retinae of postnatal day 2 (PN2), PN7, and PN14 wild type (wt) and retinal degeneration 1 (rd1) mice were quantified, labeled and used for lectin-microarray profiling with immobilized lectins which recognize a wide range of N-/O-glycans. Net fluorescence intensities of lectin-ligand complexes were measured and images of fluorescent lectin-microarrays were acquired. From the binding curves between each lectin and protein extracts from PN14 wt and PN14 rd1 mice retinae, the protein concentration was selected to determine optimum signal intensity for lectin-ligand binding. Mean±SEM values of proteins and fluorescence-intensities of lectin-ligand-complexes between 45 lectins and 36 protein extracts from wt and rd1 mice retinae were compared for significance of differences. RESULTS: Comparison of the progressive relative changes in the sialylated glycans of retinal proteins from wt and rd1 mice showed that Siaα2-3Galβ1-4GlcNAc-glycans (but not Siaα2-6-glycans) were detectable and quantifiable from the retinal-proteins of PN7 and PN14 wt and rd1 mice. Siaα2-3-sialylation of retinal-protein Gal/α-linked-Gal-glycans was significantly increased with age in PN7 and PN14 wt and less so in PN14 rd1 mice. Siaα2-3-/Siaα2-6-sialylation of retinal-protein Gal/α-linked-Gal-glycans was absent in PN2 wt and rd1 mice. Comparison of published ERG responses of wt and rd1 mice retinae with degree of Siaα2-3-sialylation of retinal-protein-glycans showed that PN2 wt and rd1 mice lack both the ERG response and Siaα2-3-/Siaα2-6-sialylation of retinal-protein Gal/α-linked-Gal-glycans; rd1 mice with relatively lower Siaα2-3-sialylation of retinal-protein Gal/α-linked-Gal-glycans showed aberrant ERG response; and wt mice with significantly higher Siaα2-3-sialylation of retinal-protein Gal/α-linked-Gal-glycans showed normal ERG response. CONCLUSION: Degree of Siaα2-3-sialylation of glycans possibly regulates ERG function in mice.

    • Identification of rare paired box 3 variant in strabismus by whole exome sequencing

      2017, 10(8):1223-1228. DOI: 10.18240/ijo.2017.08.06 CSTR:

      Abstract (1191) HTML (221) PDF 636.92 K (623) Comment (0) Favorites

      Abstract:AIM: To identify the potentially pathogenic gene variants that contributes to the etiology of strabismus. METHODS: A Chinese pedigree with strabismus was collected and the exomes of two affected individuals were sequenced using the next-generation sequencing technology. The resulting variants from exome sequencing were filtered by subsequent bioinformatics methods and the candidate mutation was verified as heterozygous in the affected proposita and her mother by sanger sequencing. RESULTS: Whole exome sequencing and filtering identified a nonsynonymous mutation c.434G-T transition in paired box 3 (PAX3) in the two affected individuals, which were predicted to be deleterious by more than 4 bioinformatics programs. This altered amino acid residue was located in the conserved PAX domain of PAX3. This gene encodes a member of the PAX family of transcription factors, which play critical roles during fetal development. Mutations in PAX3 were associated with Waardenburg syndrome with strabismus. CONCLUSION: Our results report that the c.434G-T mutation (p.R145L) in PAX3 may contribute to strabismus, expanding our understanding of the causally relevant genes for this disorder.

    • >Clinical Research
    • Association of the macrophage migration inhibitory factor promoter polymorphisms with benign lymphoepithelial lesion of lacrimal gland

      2017, 10(8):1229-1232. DOI: 10.18240/ijo.2017.08.07 CSTR:

      Abstract (1338) HTML (226) PDF 409.47 K (631) Comment (0) Favorites

      Abstract:AIM: To identify the association of the macrophage migration inhibitory factor (MIF) gene polymorphism with the susceptibility of benign lymphoepithelial lesions (BLEL) of the lacrimal gland. METHODS: A total of 40 BLEL of lacrimal gland cases were matched with 40 healthy subjects (HS). Extraction the plasma and whole blood DNA of patients of lacrimal gland BLEL and HS. Elisa and polymerase chain reaction was used to determine in plasma contents of MIF and MIF gene SNP-173G>C and STR -794 CATT(5-8) polymorphism, respectively. RESULTS: The MIF levels in plasma were significantly higher in patients with lacrimal gland BLEL versus HS (P<0.001). The -173 G>C MIF polymorphism was significantly associated with lacrimal gland BLEL, with a significantly higher frequency of the C allele in lacrimal gland BLEL patients compared with HS (OR=2.38, 95% CI=1.07-5.31, P=0.032), and the -173 C/x is more frequent in patients than in HS, P=0.037. Besides, we found that the carriage rate of the MIF -173C/x is associated with higher plasma levels of MIF in the BLEL of lacrimal gland. CONCLUSION: MIF -173G/C variants play an insidious role in susceptibility of BLEL of lacrimal gland. Otherwise, there is no statistically significant correlation exists between MIF-794 CATT (5-8) and BLEL of lacrimal gland.

    • Diurnal macular choroidal area fluctuation in normal and primary open angle glaucoma groups

      2017, 10(8):1233-1238. DOI: 10.18240/ijo.2017.08.08 CSTR:

      Abstract (1300) HTML (230) PDF 890.76 K (592) Comment (0) Favorites

      Abstract:AIM: To assess and compare the diurnal macular choroidal area fluctuation in normal and primary open angle glaucoma (POAG) groups using enhanced depth imaging optical coherence tomography (EDI-OCT). METHODS: Twenty-eight normal and 27 POAG eyes were enrolled in this study. EDI-OCT was used to measure the macular choroidal area every 3h from 9:00 a.m. to 21:00 p.m. RESULTS: Significant diurnal fluctuations of macular choroidal area were observed in both normal (P=0.003) and POAG groups (P<0.001). But no significant macular choroidal area difference has been found between the two groups at all the five measurement time-points (512778±166242 vs 455079±207278 μm2, P=0.195 at 9:00 a.m.; 501526±168953 vs 447846±211147 μm2, P=0.245 at 12:00 a.m.; 501982±173158 vs 448024±206653 μm2, P=0.239 at 15:00 p.m.; 508912±174589 vs 457783±207081 μm2, P=0.252 at 18:00 p.m.; 503787±171241 vs 453230±205955 μm2, P=0.274 at 21:00 p.m.; respectively). Furthermore, neither the fluctuation manners nor the change in macular choroidal area between the two adjacent measurement time points showed significant difference between normal and POAG groups (all P>0.05). In the meantime, significant diurnal intraocular pressure fluctuations were also observed in normal and POAG groups (both P<0.001). CONCLUSION: In diurnal time, the macular choroidal area in both normal and POAG groups fluctuated significantly; moreover, neither the value of macular choroidal area, nor the fluctuation of macular choroidal area in POAG group is significantly different from that in normal group.

    • The change of anterior segment parameters after cataract surgery in normal-tension glaucoma

      2017, 10(8):1239-1245. DOI: 10.18240/ijo.2017.08.09 CSTR:

      Abstract (2625) HTML (234) PDF 540.08 K (1062) Comment (0) Favorites

      Abstract:AIM: To investigate the change of anterior chamber angle morphology and intraocular pressure (IOP) reduction after cataract surgery in patients with normal-tension glaucoma (NTG) using swept-source optical coherence tomography (SS-OCT). METHODS: This prospective, comparative, observational study recruited patients into two groups. Group 1 was the control group including normal subjects except those with cataracts (cataract group, n=67 eyes of 67 patients), and group 2 was NTG group including patients who were diagnosed with NTG and cataracts (n=43 eyes of 43 patients), which were treated with phacoemulsification and intraocular lens implantation. Before surgery, and at postoperative 1 and 6mo, anterior chamber angles were evaluated by SS-OCT under dark conditions using three-dimensional angle analysis scan protocol. Angle opening distance (AOD), angle recess area (ARA), and trabecular-iris surface area (TISA) at four quadrants (temporal, nasal, superior, and inferior) were calculated automatically by SS-OCT, after the observer marked scleral spurs. RESULTS: A total of 106 patients (54 males and 52 females) were enrolled in the study. Angle parameters, AOD, ARA, and TISA were increased after surgery in both groups. However, changes of angle parameters were only significant in group 2. In group 2, preoperative IOP was 13.2±2.9 mm Hg, and postoperative IOP at 1 and 6mo were 10.5±3.0 and 10.7±2.8 mm Hg, respectively. In group 1, preoperative IOP was 12.4±2.8 mm Hg, and postoperative IOP at 1 and 6mo were 11.6±2.5 and 12.0±2.8 mm Hg, respectively. After cataract surgery, angle parameters changed significantly while IOP significantly reduced and was maintained in group 2 (P<0.001). The changes in angle parameters (ΔAOD500, ΔTISA500 at temporal; ΔAOD500, ΔARA500 at nasal) were linearly correlated with postoperative IOP changes. CONCLUSION: Cataract surgery may have improved anterior chamber angle parameters and decreased IOP in NTG patients.

    • Refractive errors and biometry of primary angle-closure disease in a mixed Malaysian population

      2017, 10(8):1246-1250. DOI: 10.18240/ijo.2017.08.10 CSTR:

      Abstract (1515) HTML (226) PDF 303.89 K (617) Comment (0) Favorites

      Abstract:AIM: To assess the refractive status, anterior chamber depth (ACD) and axial length (AL) of patients with primary angle-closure disease (PACD). METHODS: Retrospective cohort. Data was collected from charts of all PACD patients treated from April 2013 to December 2015. Analysis was done on 137 patient charts with complete biometric data. Patient demographics, PACD type, refractive status (spherical equivalent), ACD and AL were studied. RESULTS: The median age of 137 subjects [53 with primary angle-closure suspects (PACS), 27 with primary angle-closure (PAC) and 57 with primary angle-closure glaucoma (PACG)] was 68y (range 21-88y). The majority was Chinese (n=68; 49.6%) and most of them were women (n=75; 54.7%). The distribution of myopia (n=51; 37.2%) and hyperopia (n=49; 35.8%) was similar. The ACD was shallower in myopes compared to hyperopes (P=0.02) and emmetropia (P=0.049) but the AL was not significantly different between groups. There were no patients blind from PACG. CONCLUSION: Both myopia and hyperopia can occur in PACD. Despite a shallower ACD in angle closure myopes, the AL was not different between groups.

    • Efficacy and safety of bimatoprost in glaucoma and ocular hypertension in non-responder patients

      2017, 10(8):1251-1254. DOI: 10.18240/ijo.2017.08.11 CSTR:

      Abstract (1705) HTML (225) PDF 290.14 K (599) Comment (0) Favorites

      Abstract:AIM: To establish the efficacy and safety of bimatoprost 0.03% monotherapy in glaucoma and ocular hypertension (OHT) patients with inadequate intraocular pressure (IOP)on current therapy. METHODS: Pre- and post-switch IOPs were analyzed for 59 consecutive patients who were switched from current therapy to bimatoprost monotherapy between 2011-2015. Demographic information, diagnosis, and any adverse events were recorded. Change in IOP post-pre switch was analyzed using a 2-sided Student's paired t-test at the 5% significance level. RESULTS: There was a statistically significant mean reduction in IOP at the first follow up visit, which was maintained at subsequent follow up visits for patients regardless of diagnosis, or pre-switch treatment (P<0.001). Subgroup analysis also demonstrated a statistically significant mean reduction in IOP when looking at OHT patients only, as well as patients with any diagnosis switched from latanoprost monotherapy to bimatoprost monotherapy (P<0.001). CONCLUSION: This is the largest independent data set which supports switching glaucoma patients with poor response to current treatment onto bimatoprost monotherapy before considering other adjuvant medical or more invasive therapy.

    • Area and volume ratios for prediction of visual outcome in idiopathic macular hole

      2017, 10(8):1255-1260. DOI: 10.18240/ijo.2017.08.12 CSTR:

      Abstract (2138) HTML (225) PDF 791.28 K (676) Comment (0) Favorites

      Abstract:AIM: To predict the visual outcome in patients undergoing macular hole surgery by two novel three-dimensional morphological parameters on optical coherence tomography (OCT): area ratio factor (ARF) and volume ratio factor (VRF). METHODS: A clinical case series was conducted, including 54 eyes of 54 patients with an idiopathic macular hole (IMH). Each patient had an OCT examination before and after surgery. Morphological parameters of the macular hole, such as minimum diameter, base diameter, and height were measured. Then, the macular hole index (MHI), tractional hole index (THI), and hole form factor (HFF) were calculated. Meanwhile, novel postoperative macular hole (MH) factors, ARF and VRF were calculated by three-dimensional morphology. Bivariate correlations were performed to acquire asymptotic significance values between the steady best corrected visual acuity (BCVA) after surgery and 2D/3D arguments of MH by the Pearson method with two-tailed test. All significant factors were analyzed by the receiver operating characteristic (ROC) curve analysis of SPSS software which were responsible for vision recovery. ROC curves analyses were performed to further discuss the different parameters on the prediction of visual outcome. RESULTS: The mean and standard deviation values of patients’ age, symptoms duration, and follow-up time were 64.8±8.9y (range: 28-81), 18.6±11.5d (range: 2-60), and 11.4±0.4mo (range: 6-24), respectively. Steady-post-BCVA analyzed with bivariate correlations was found to be significantly correlated with base diameter (r=0.521, P<0.001), minimum diameter (r=0.514, P<0.001), MHI (r= -0.531, P<0.001), THI (r=-0.386, P=0.004), HFF (r=-0.508, P<0.001), and ARF (r=-0.532, P<0.001). Other characteristic parameters such as age, duration of surgery, height, diameter hole index, and VRF were not statistically significant with steady-post-BCVA. According to area under the curve (AUC) values, values of ARF, MHI, HFF, minimum diameter, THI, and base diameter are 0.806, 0.772, 0.750, 0.705, 0.690, and 0.686, respectively. However, Steady-post-BCVA analysis with bivariate correlations for VRF was no statistical significance. Results of ROC curve analysis indicated that the MHI value, HFF, and ARF was greater than 0.427, 1.027 and 1.558 respectively which could correlate with better visual acuity. CONCLUSION: Compared with MHI and HFF, ARF could effectively express three-dimensional characteristics of macular hole and achieve better sensitivity and specificity. Thus, ARF could be the most effective parameter to predict the visual outcome in macular hole surgery.

    • Role of short-wavelength filtering lenses in delaying myopia progression and amelioration of asthenopia in juveniles

      2017, 10(8):1261-1267. DOI: 10.18240/ijo.2017.08.13 CSTR:

      Abstract (2692) HTML (236) PDF 329.65 K (712) Comment (0) Favorites

      Abstract:AIM: To evaluate the positive effects of blue-violet light filtering lenses in delaying myopia and relieving asthenopia in juveniles. METHODS: Sixty ametropia juveniles (aged range, 11-15y) were randomized into two groups: the test group (30 children, 60 eyes), wearing blue-violet light filtering lenses; and the control group (30 children, 60 eyes), wearing ordinary aspherical lenses. Baseline refractive power of the affected eyes and axial length of the two groups was recorded. After 1-year, the patients underwent contrast sensitivity (glare and non-glare under bright and dark conditions), accommodation-related testing, asthenopia questionnaire assessment, and adverse reaction questionnaire assessment. RESULTS: After 1y of wearing the filtering lenses, changes in refractive power and axial length were not significantly different between the two groups (P>0.05). Under bright conditions, the contrast sensitivities at low and medium-frequency grating (vision angles of 6.3°, 4.0°, and 2.5°) with glare in the test group were significantly higher than in the control group (P<0.05), while the contrast sensitivity at low-frequency grating (vision angles of 6.3° and 4.0°) in the absence of glare in the test group was higher than in the control group (P<0.05). Under glare and non-glare dark conditions, the contrast sensitivities of various frequencies in the test group did not show significant differences compared with those in the control group (P>0.05). In the test group, the amplitude of accommodation, accommodative lag, and accommodative sensitivity of patients wearing glasses for 6 and 12mo were significantly elevated (P<0.05), while the asthenopia gratings were significantly decreased (P<0.05). Nevertheless, in the control group, the amplitude of accommodation, accommodative lag, and accommodative sensitivity after 12mo were not significantly altered compared with baseline (P>0.05), and the asthenopia grating was not significantly decreased (P>0.05). In addition, after wearing glasses for 6 to 12mo, the asthenopia grating of patients in the test group decreased significantly compared with the control group (P<0.05). At 12mo, the constituent ratio of adverse reactions did not show significant difference between the two groups (P>0.05). CONCLUSION: A 1-year follow-up reveal that compare with ordinary glasses, short-wavelength filtering lenses (blue/violet-light filters) increase the low- and medium-frequency contrast sensitivity under bright conditions and improved accommodation. They effectively relieved asthenopia without severe adverse reactions, suggesting potential for clinical application. However, no significant advantages in terms of refractive power or axial length progression were found compared with ordinary aspheric lenses.

    • Epstein-Barr virus-encoded small RNAs in idiopathic orbital inflammatory pseudotumor tissues: a comparative case series

      2017, 10(8):1268-1272. DOI: 10.18240/ijo.2017.08.14 CSTR:

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      Abstract:AIM: To investigate the positive rate and types of cells that express Epstein-Barr virus-encoded small RNAs (EBERs) and to determine the distribution of EBER-expressing cells in idiopathic orbital inflammatory pseudotumor (IOIP) tissues. METHODS: We retrospectively examined 40 archived paraffin specimens from two teaching hospitals in Southern China between January 2007 and January 2015 that were pathologically determined to exhibit IOIP. Eleven concurrent paraffin specimens of thyroid-associated ophthalmopathy (TAO) composed the control group. In situ hybridization was performed to detect EBERs. Immunohistochemistry was employed to detect CD3, CD20, Vimentin, and smooth muscle actin (SMA), and the positive rate, types of positive cells, and distribution and location of EBERs were evaluated. RESULTS: The positive expression rate of EBERs was 47.5% (19/40) in the IOIP group, which was significantly higher than that in the TAO group [0 (0/11), P=0.011]. In the IOIP group, the lymphocyte infiltrative subtype, fibrotic subtype, and mixed subtype exhibited EBER-positive rates of 57.1% (12/21), 12.5% (1/8), and 54.5% (6/11), respectively, and no significant differences were found between these subtypes (P=0.085). Positive signals of EBERs were mainly present in medium-small lymphocytes between or around follicles and in the nuclei of activated immunoblasts (14/19). CONCLUSION: The positive rate, types, and distribution of EBER-expressing cells in IOIP have been documented. These findings are conducive for a better understanding of the underlying mechanisms of Epstein-Barr virus infection in IOIP pathogenesis.

    • >Meta-Analysis
    • Prevalence of retinopathy of prematurity in Iran: a systematic review and Meta-analysis

      2017, 10(8):1273-1279. DOI: 10.18240/ijo.2017.08.15 CSTR:

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      Abstract:AIM: To estimate overall prevalence of retinopathy of prematurity (ROP) in Iran using a systematic review and Meta-analysis. METHODS: A systematic review and Meta-analysis was performed of all published studies pertaining to prevalence of ROP using international and national electronic databases (ISI Web of Sciences, PubMed, Scopus, Google Scholar, SID, MagIran, and IranMedex) from their inception until May 2016 with standard keywords. Begg and Egger tests were used to examine the publication bias and Cochran test and I2 statistics were used to evaluate the statistical heterogeneity. Pooled estimate of the prevalence of ROP were calculated using random effects Meta-analysis. RESULTS: The publication bias assumption was rejected by Egger tests with P-value equal to 0.024. The results of Cochran test and I2 statistics revealed substantial heterogeneity (Q=1099.02, df=25, I2=97.7%, P=0.001). The overall prevalence of ROP using the random effect model in Iran was 26.1% (95% CI: 20.3%-31.8%). CONCLUSION: The prevalence of ROP is relatively high in Iran. Low birth weight and gestational age are significant risk factors for the disease. Improved care, including oxygen delivery and monitoring, for preterm babies in all facility settings would reduce the number of babies affected with ROP.

    • Combined therapy versus anti-vascular endothelial growth factor monotherapy for polypoidal choroidal vasculopathy: a Meta-analysis

      2017, 10(8):1280-1289. DOI: 10.18240/ijo.2017.08.16 CSTR:

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      Abstract:AIM: To evaluate the efficacy and safety of anti-vascular endothelial growth factor (VEGF) combined with photodynamic therapy (PDT) versus anti-VEGF monotherapy for polypoidal choroidal vasculopathy (PCV). METHODS: We conducted a Meta-analysis of 9 studies to compare the efficacy and safety between combined therapy and anti-VEGF monotherapy for PCV. The programs of RevMan 5.3 and Stata 12.0 were used to analyze data. RESULTS: The best corrected visual acuity (BCVA) in combined therapy group were significantly better than those of anti-VEGF monotherapy group at 6, 24 and 36mo, with pooled weighted means differences (WMDs) of 0.12 (0.06, 0.18), 0.25 (0.12, 0.38) and 0.28 (0.13, 0.43), respectively. The central retinal thickness (CRT) reductions in combined therapy group were higher than that in anti-VEGF monotherapy group at 1, 3, 6 and 9mo, with pooled WMDs of 63.90 (20.41, 107.38), 33.47 (4.69, 62.24), 30.57 (0.12, 60.01) and 28.00 (2.51, 53.49), respectively. The regression rate of polyps in combined therapy group was much higher than that in anti-VEGF monotherapy group [RD: 0.47 (0.26, 0.68); P<0.0001]. The adverse event retinal hemorrhage did not differ significantly between the two groups. CONCLUSION: Our findings clearly document that anti-VEGF combined with PDT is a more effective therapy for PCV compared with anti-VEGF monotherapy. Furthermore, combined therapy does not increase the incidence of retinal hemorrhage.

    • >Investigation
    • The evolution of refractive status in Chinese infants during the first year of life and its affected factors

      2017, 10(8):1290-1294. DOI: 10.18240/ijo.2017.08.17 CSTR:

      Abstract (1586) HTML (231) PDF 759.78 K (649) Comment (0) Favorites

      Abstract:AIM: To study the evolution of the refractive status and examine the affected factors in infants during the first year of life in a large sample size in China. METHODS: A total of 1258 babies (2516 eyes) aged 32wk gestational age to 1y participated in the study, including 766 premature and 492 full-term infants. First, each baby received an orthoptic examination, slit-lamp checking and fundus imaging. Patients with diseases which might affect refractive status were excluded from the cohort. The cycloplegia retinoscopy was performed. Their neonatal histories were reviewed. Each measurement contained the refractive status and calculation of the spherical equivalent (SE). RESULTS: Refractive state showed an average hyperopia of +0.94±1.63 D at early ages, followed by a trend toward more hyperopia. The refractive state reached the top (+2.43±1.46 D) at the age of one to two months. Then gliding till one year old when the refractive state reached +0.59±1.41 D. The prevalence of astigmatism was 42.17% in the study, being 2.82% myopic astigmatism and 39.35% hyperopic astigmatism. The 94.1% of hyperopic astigmatism was with-the-rule astigmatism and 71.83% of myopic astigmatism was with-the-rule astigmatism. Refractive state between boys and girls was different. The mean SE of boys was +1.97±1.57 D, while that of girls was +1.79±1.46 D, and the difference was significant. CONCLUSION: Before one year old, the change of refractive status is associated with checking age and sex. At the age of one to two months, the degree of hyperopia reaches the top. Boys have more hyperopic degree than girls, and with-the-rule astigmatism is predominant. Excluding premature infants with advanced retinopathy of prematurity, premature and full-term children have same refraction status.

    • Epidemiologic characteristics and outcomes of open globe injury in Shanghai

      2017, 10(8):1295-1300. DOI: 10.18240/ijo.2017.08.18 CSTR:

      Abstract (1184) HTML (221) PDF 492.09 K (664) Comment (0) Favorites

      Abstract:AIM: To investigate the epidemiologic characteristics and outcomes of open globe injury in Shanghai. METHODS: A retrospective study was conducted for 148 unilateral open globe injury cases presenting to a tertiary referral hospital of Shanghai. Electronic medical records were reviewed and phone surveys were conducted to collect and analyze 1) background of patient; 2) setting of injury and clinical signs at presentation; 3) treatment procedure and outcome; 4) quality of life after injury. RESULTS: There were more male patients (77.03%) than females (22.97%), more temporary habitants (79.05%) than residents (20.95%). The subjects in this study presented a significantly lower constitutional status of education than that of the whole Shanghai population (P<0.001). Occupational injury was the first cause of injuries (39.86%), followed by home accident (20.27%), road accident (16.89%), violent behavior (16.89%) and outdoor injury (6.08%). The 143 subjects (96.62%) were not wearing spectacles at the time of injury. Of all patients, 77 subjects (52.03%) had the outcome of no vision (including enucleation). The classification and regression tree (CART) prognosis presents 59.58% sensitivity to predict visual survival correctly and 80.19% specificity to predict no vision correctly. The patients whose injured eye had no vision reported more reduction of life quality. CONCLUSION: We found that male subject, temporary habitants, low educational status and no eyewear are risk factors of open globe injury in Shanghai. Occupational injury is the leading cause. CART analysis presents a certain agreement to the actual visual outcome. The injury imposes negative impact on quality of life especially in no vision cases. The education of eye protection may help to avoid the injury.

    • >Review
    • Intraocular lymphoma

      2017, 10(8):1301-1307. DOI: 10.18240/ijo.2017.08.19 CSTR:

      Abstract (2669) HTML (238) PDF 1002.78 K (911) Comment (0) Favorites

      Abstract:Intraocular lymphoma (IOL) is a rare lymphocytic malignancy which contains two main distinct forms. Primary intraocular lymphoma (PIOL) is mainly a sub-type of primary central nervous system lymphoma (PCNSL). Alternatively, IOL can originate from outside the central nervous system (CNS) by metastasizing to the eye. These tumors are known as secondary intraocular lymphoma (SIOL). The IOL can arise in the retina, uvea, vitreous, Bruch’s membrane and optic nerve. There are predominantly of B-cell origin; however there are also rare T-cell variants. Diagnosis remains challenging for ophthalmologists and pathologists, due to its ability to masquerade as noninfectious or infectious uveitis, white dot syndromes, or occasionally as other metastatic cancers. Laboratory tests include flow cytometry, immunocytochemistry, interleukin detection (IL-10: IL-6, ratio >1), and polymerase chain reaction (PCR) amplification. Methotrexate-based systemic chemotherapy with external beam radiotherapy and intravitreal chemotherapy with methotrexate are useful for controlling the disease, but the prognosis remains poor. Therefore, it is important to make an early diagnose and treatment. This review is focused on the clinical manifestations, diagnosis, treatment and prognosis of the IOL.

    • Metalloproteinases as mediators of inflammation and the eyes: molecular genetic underpinnings governing ocular pathophysiology

      2017, 10(8):1308-1318. DOI: 10.18240/ijo.2017.08.20 CSTR:

      Abstract (1901) HTML (235) PDF 677.42 K (622) Comment (0) Favorites

      Abstract:There are many vision threatening diseases of the eye affecting millions of people worldwide. In this article, we are summarizing potential role of various matrix metalloproteinases (MMPs); the Zn (2+)-dependent endoproteases in eye health along with pathogenesis of prominent ocular diseases such as macular degeneration, diabetic retinopathy, and glaucoma via understanding MMPs regulation in affected patients, interactions of MMPs with their substrate molecules, and key regulatory functions of tissue inhibitor of metalloproteinases (TIMPs) towards maintaining overall homeostasis.

    • Cysticercosis of the eye

      2017, 10(8):1319-1324. DOI: 10.18240/ijo.2017.08.21 CSTR:

      Abstract (1883) HTML (227) PDF 1.10 M (782) Comment (0) Favorites

      Abstract:Cysticercosis is a preventable and eradicable cause of blindness endemic in the Indian subcontinent, South- East Asia and other developing countries. Ocular and orbital cysticercosis has varied presentations depending upon the site of involvement, number of lesion and the host immune response. In this article we present a review of the various clinical manifestations, diagnosis and management protocol for orbital and ocular cysticercosis. Owing to its varied presentation, cysticercosis may pose a diagnostic challenge to the health professionals. Early diagnosis and management can prevent the vision loss and optimize visual outcomes.

    • >Letter to the Editor
    • A case of non-Acanthamoeba keratitis with radial keratoneuritis

      2017, 10(8):1325-1327. DOI: 10.18240/ijo.2017.08.22 CSTR:

      Abstract (1374) HTML (229) PDF 544.15 K (737) Comment (0) Favorites

      Abstract:Letter to the Editor

    • Optical coherence tomography-angiography of juxtapapillary hamartoma

      2017, 10(8):1328-1330. DOI: 10.18240/ijo.2017.08.23 CSTR:

      Abstract (1138) HTML (235) PDF 1.66 M (598) Comment (0) Favorites

      Abstract:Letter to the Editor

    • Spectral-domain optical coherence tomography dynamic changes and steroid response in multiple evanescent white dot syndrome

      2017, 10(8):1331-1333. DOI: 10.18240/ijo.2017.08.24 CSTR:

      Abstract (1442) HTML (228) PDF 1.09 M (610) Comment (0) Favorites

      Abstract:Letter to the editor

    • >Comment and Response
    • Comment on “Comparison of 45-degree Kelman and 45-degree balanced phaco tip designs in torsional microcoaxial phacoemulsification”

      2017, 10(8):1334-1336. DOI: 10.18240/ijo.2017.08.25 CSTR:

      Abstract (1186) HTML (221) PDF 270.49 K (565) Comment (0) Favorites

      Abstract:Letter to the Editor

Editors-in-Chief: Yan-Nian Hui and Peter Wiedemann

Established in April, 2008

ISSN 2222-3959 print

ISSN 2227-4898 online

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